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PAGE
Abortion, Self-produced, and its Consequences 178
Abscess, Mammary ' 91
"Advance," Cincinnati Medical .....115
Advertising, Medical .135
Advice to Students about to Graduate 31
Agassiz, Prof. . . . . . 196
Alcoholic Stimulants . 73
Alcohol, Dr. Lionel S. Beale on the Action of 166
Allopath, An Astonished , 58
Allopathic Courtesy 255
Allopathy vs. Homoeopathy , 133
American Cyclopedia 236
Amputations, Lines of Incision for Rapid. ......... 131
Anaesthesia, Inventor of 252
Anaesthetics, History of , 135
Anatomy, Physiology and Hygiene 96
Aneurism, Galvano- Acupuncture for Aortic 58
Animation, Suspended, Treated with Dry Heat 90
Antidote to Opium, Atropine as an 215
Anti-Dysenteric, New 210
An ti- Periodic, New 144
Antiquities 24
Anus, Imperforate 191
Arteries of the Tegument in Fever, Condition of. . . .215
Arteries, Torsion of 94
Artery, Ligature of the Femoral 131
Asphyxia in Breech Presentations. 131
Association., Alumni, of the College of Physicians and
Surgeons ... 108
Association, American, for the Advancement of Science 216
Association, Medical Science 21, 69, 93
Association, Public Health 22
Asylum, California Insane 47
Asylum, N. Y. State Homoeopathic Insane, 157, 159,
[251, 254
Asylum, Oldest Lunatic, in America 240
Asylum, Southern Ohio Lunatic 47
Asylum, Ward's Island Insane 47
Atmosphere , 236
Atmospheric Wave 23
Atropine . 129
Attenuations, Vitality of High . , 202
Aural Catarrh 138
Bacon, Dr 168
Barker, Dr. Fordyce . . 47
Beakley, Dr. Jacob 24
Berlin, A Letter from 183
Bladder, Fibroid Tumor of, Treated by Muriate of
"Ammonia 10
Bladder of a Female, A Wax Candle in the ........ 288
Bladder, Treatment of Chronic Diseases of 237
Boils, How to Arrest the Development of 58
Burns . . 264
Brain Disease 123, 158
Breast, Adenoma of 'the 89
Bright' s Disease, Chronic 94
Buchner, Prof. 144
G PAGE
California: For Health, Pleasure and Residence ... 18
Cancer, Diagnosis of 224
Cancer, How to Distinguish from Innocent Growths, 143
Cancer of the Skin, Development of 191
Cancerous Sores, Local Employment of Chlorate of
Potash in 252
Cancrum Oris Successfully Treated by a Saturated
Solution of Iodine 264
Case, A Practical 196
Case, The Most Dangerous . 240
Cerebral Hyperaemia, Hamamelis in Secondary. . : . . .245
Cerebro-Spinal Affections, Gelseminum in 175
Cervix Uteri, Enlargement of, during Pregnancy. . . . 132
Chancroid and Chancre, Diagnostic Characters of. . .117
Charity Students : 63
Chemosis, Case of, Cured by Guaraea . . 272
Chloroform Intoxication . . . t 252
Cholera 145
Cholera in Nashville 193
Cholera in Russia 47
Cholera Reports, Inaccurate 231
Cholera, Temperature Observations in 240
Cholera, Transfusion in 263
Cimex Lectularius , 180
Circulation of Frogs, Experiments in the 95
Climatology, Minnesota 55, 97
Clinical Contributions 124
Cod- Liver Oil Pills 151
Cold -Taking : Its Nature, Cause, Prevention and Cure . 283
Colles' Fracture, Observations on the Treatment for. .246
Cole, Dr. H. B 24
College, Bellevue Hospital Medical 70
College of Pharmacy, Tenn 47
College of Physicians and Surgeons 71
College, New England Female Medical. , 47
College, N. Y. Homoeopathic Medical 71
Colleges, Homoeopathic Medical 118
College, University Medical 71
Conium 168
Conjunctivitis, Chronic , 144
Constipation, A Case of Obstinate 156
Constipation, Arsenic in 168
Contagion 24
Consumption, Nutrition of Lung-Tissue in 116
Convulsions, Epileptiform 1 1
Convulsions, Puerperal 241
Corns, Tincture of the Chloride of Iron for. 57
Cotton Wadding, French Method of Dressing Wounds
by 165
Crannel, John, Letter from. 11, 83, 130
Crime, Influence of Sex in 159
Croup, Membranous, A Case of, in an Adult 272
Cystitis, Sub-Acute and Chronic, Treatment of 99
Czermak, Prof. 288
D
Daltonism 288
Daremberg, Dr 47
Death, Diagnosis of, by the Pupil 94
11.
Index.
PAGE
Death from Swallowing an Artificial Tooth with Rub-
ber Plate Attached 264
Death-rate in New York for 1872 40
Deformities of the Extremities, Pathology of Certain . 269
Degrees, Medical 71
Depilatory 45
Development, Physical , 85
Development, Unilateral 288
Diabetes 158
Diabetes Cured by Lactic Acid 252
Diabetes M'ellitus, Cure for ... . 116
Diabetes Mellitus, New Cause of 45
Diseases of Women, Lectures on 16
Disinfectant, Chloride of Calcium as a 167
Disinfectants 24
Dislocation of the Head of the Femur, in an Aged
Patient 88
Dispensary, Albany City 71
Dispensary, Bond Street Homoeopathic 211
Dispensary, Cases from Practice 102
Dispensary, Western Homoeopathic 48, 192
Dysmenorrhcea, Dilatation of the Cervix Uteri in. . .252
Dyspepsia, Anaemia and Chlorosis, Functional 59
Dyspepsia, Treatment of, Without Medicine 169
E
Echises Scholaris and the Garcinia Mangostana. . . .287
Eczema Treated with Concentrated Petroleum 60
Education, American Medical 112
Education, Elevation of the Standard of Medical, . . 184
Education, Medical ... 205
Egypt, Khedive of , 288
Electro Therapeutics, Practical 21
Embalming, The Burnette Process of .' . . 287
Emperor of Austria 95
Empress of Austria 47
Epilepsy, Chloride of Potassium in 232
Eruptive Diseases, Blood in , 45
Essays, Prize 168
Eustachius, A Proposed Monument to 288
Excretine and What it Suggests 79
Extracts, Elegant 206
Eye, Encephaloid and Scirrhus Cancer of 90
F
Fees, Large "... 47
Fever, Intermittent 24
Fibrin, Artificial, from the White of Egg 287
Flint, Dr. Austin 47
Franklin, Prof. E. C 47
Future, The 253
G
Gastrotomy, Placenta in 132
Gegenbauer, Prof ". .240
German Language, Ahn's Rudiments of 214
Glue, Liquid " ... 57
Glycerine 45
Gonhorrhcea 144
Gonhorrhcea, Treatment of, byTanno- Glycerine Paste 286
Guernsey, Dr. Wm. A 24
H
Hahnemann, Brooklyn's Monuments in Memory of . . 61
Hahnemann, Widow of 144
Health, Annual Report of the Board of 20
Hemorrhoids in Parturient Women 272
Hemorrhage, Terebinth in 60
Flemorrhoids, Urethral 180
Hercules' Help 277
Hermaphrodism, A Curious Case of 80
Hering's Analytical Therapeutics 238
PAGE
Hernia, Hemorrhoidal 88
Hip-Joint, Anchylosis of the 46
Holloway 47
Home for the Friendless , . 120 I
Homoeopathic Congress, British 24
Homoeopathic Literature, Annual Record, 1873.. ..285
Homoeopathic Physicians and Surgeons, Cleave' s
Biographical Cyclopedia of 211
Homoeopathic Visiting List 281
Homoeopathic Recognition 45
Homoeopathic Therapia, Bonninghau sen's 235
Homoeopathy, American Institute of no, 120, 139
Homoeopathy, Appropriation of, by the Old School. . . 81
Homoeopathy in Jamaica . 48
Homoeopathy, Science of 97 .
Homoeopathy, St. Louis Academy of 47
Hospitals 134
Hospital, Albany City Homoeopathic 95
Hospital and Lying-in Asylum, Columbia 212
Hospital Attendance, Importance of 5&
Hospital, Bellevue » 71
Hospital, 'Brooklyn Homoeopathic 24, 72, 134, 201
Hospital, Chicago Homoeopathic 7°
Hospital, Guy's, Garotting at ... 23
Hospital, Harrisburg 216
Hospital, Hahnemann 24
Hospital, N. Y. Ophthalmic 24
Hospital of Chicago, Scammon 7°
Hospital, Philadelphia Jewish 4&
Hospital, The Woman's 7r
Houghton, Dr. T : 258
Huxley, Prof , 264
Hydrophobia, A Few Remarks on 155
Hygiene 7°
Hygiene, Mental , 284
I
Infancy, Oreide of Zinc in the Diarrhoeas of 214
Infancy, Perils of ■. 121
Infancy, Podophylline in the Diarrhoeas of 215
Infants in the Manufacturing Districts of England,
Death-rate of 287
Infirmary, Clinic of the Brooklyn Homoeopathic Eye
and Ear 151
Influenza, Causes of Horse ."•• 95
Inhalation, Use of Spiritus Terebinthinse by 273
Injections, Nutritious . , 288
Insanity 86
Ingrowing Toe-nail. 46
Intermittent Fevers, A New Method of Treating. . . . 144
International Scientific Series 17
Iodoform, Topical Action of. 217
Journals, New . . • • 48
Journal of Flomceopathy, N. Y . 115
Journal, Our 109
Juniper Tar-Soap 57
L
Labor, Case of 9&
Lactation, Fatty Liver during 57
Lamp Shades, Paper 45
Laryngitis, Syphilitic , 226
Laryngoscopy, Clinical 1 1 A 129
Lead-Poisoning 144
Lebarre, M ' 240
Legislation, Medical in
Leprosy, Curing , 252
Leprosy in the Sandwich Islands 257
Lesson of the Hour 230 |
Ligature, New *92
Light, Artificial 238
Index.
in.
PAGE
Lipomata, Cure of, by Alcoholic Injections 192
Liquor Sodse Chlorinatse ........ . , 276
Lithotomy, First Operation of , ,263
Liver, Abscess of the, Opening into the Ascending
Cava , 264
Liver, Cysts, in Childhood 46
Local Diseases, Relations of, to the Nature of the Soil . 46
Longevity 33
Longevity, Human 236
Longevity of Married and Single Life, Comparative. .214
M
Madeira as a Health Resort -. , 238
Mania 60
Mania, Acute, Treated by the Wet Pack 59
Marvels of Nature, Science and Art 17
Materia Medica, Characteristic 263
Maternitie, Brooklyn . . . .24, 118
Maternitie, Glasgow ....118
Maxilla, Bisection of Inferior 6
Maxilla, Giant Celled Sarcoma of the Inferior 89
Maxilla, Mercurial Necrosis of the Inferior 42
Medical Congress at Vienna 240
Medical Congress, International 239
Medical Hand-Book for Mothers . . , 236
Medical Register and Directory of the U. S 256
Medical Union I, 37
Medical Union Clinic - 258
Medicine, Future of 61
Medicine, Music as 265
Medicine, Schools of 197
Meningitis, Cerebro-Spinal 2
Menstruation, Physiology of 213
Mercury in the Excretions 191
Microscope and Microscopic Technology , 163
Midwifery, Manual of. 260
Morbus Brighti 91
Mortality among Clergymen 288
Mortality of Boston • 70
Mortuary Report in New York 96
Mott, Widow of the late Valentine 168
Muriate of Ammonia 46
Museum, American, of Natural History 288
N
Napoleon III, Post-Mortem of 41, 47
National Medical Library 48
Nelaton, Dr. Auguste 240, 264
Newly-Born Children, The Resuscitation of 167
Nose, Building up a . , 59
Notice, Editorial 13
Nurseries 106
Nurses, N. Y. State School for Training .216, 249
Nursery, Brooklyn 96
Obermier, Dr. Otto 240
Obituary , ... 24
Observatory, The Central Park 258
Ophidians 211
Obstetrics, Guernsey's 281
Obstetrics, Theory and Practice of . . 285
Ophthalmia, Epidemic 43
Ophthalmological Congress, International 47
Ophthalmoscopic Investigations 136
Opium Poisoning, Atropia in 239
Ossicles of the Ear, Mechanism of 211
Ovarian Fluid, Microscopical Appearances of 263
Ovarian Tumors, Diagnosis of 18
Ovariotomy 30
Ovariotomy followed by Twin Pregnancy 132
Ovariotomy, Observations on 150
Oxygen 264
PAGE
Ozone, by a New Process 55
Ozonizing the Air of Sick-Rooms 287
P
Paine, Dr. H. M 24, 161
Papaya 288
Paralysis, Facial 42
Paronychia, Palmaris 43
Periodicals, Medical 95
Peritonitis, Puerperal, Veratrum Viride in 42
Petroleum, Its Origin and Relation to Medicine. . .25, 49
Pharmacy, Chinese , 168
Phlegmasia Alba Dolens ... . 131
Phthisis, Chinese Use of Shad in 129
Phthisis, Laryngeal 9
Phthisis Pulmonalis, Curability of 286
Physician, Voltaire's Definition of 240
Physiology at Edinburgh, Chair of 204
Phytolacca Decandra 44
Plants in Sleeping- Rooms 264
Plaster of Paris Bandages, Removal of 143
Pleurisy, Secondary 1 76
Pleuro-Pneumonia , ... 42
Poisoning, Apomorphia in Cases of 46
Poisoning by Strychnine Treated by Chloral 101
Polypus, Fibrous, Removed from the Uterus by Elastic
Ligature 112
Poppy, Cultivation of 47
Post-Mortem Examinations 1 14
Practice, Cases from 103
Practice, Clinical Notes from 174
Practice, Two Cases from 158
Prayer Test, Substitute for 39
Pregnancy, Extra Uterine 58
Pregnancy in Primiparae of Advanced Age 173
Pregnancy in the Aged 287
Pregnancy with Imperforate Hymen 1 73
Prevention of Disease, Duty of the State in the 27
Profession, The, and the Medical Colleges 229
Prolapsus Uteri 132, 222
Pseudo-Pregnancy, A Case of 199
Pulsations, Foetal 118
Pultee, Dr 144
Q
Quinine, Action of 228
R
Rain-fall, The Effects of Forests upon 237
Rectum, Exploration of 238
Remedies, Characteristics of New 115
Re-Menstruation by the Breasts at Advanced Age. . . 130
Respiration, Researches in Regard to the. 273
Re-Vaccination, The Necessity of 144
Ring- Worm, Oleate of Mercury in 252
Rockwith, Dr. F. A .144
Romberg, Prof. 216
Salutatory 13
Sanitarian, The 7°, 163
Sanitary Legislation ' 62
Sanitary Reform in the Cooper Union 135
Sanitary Works 20
Scribner, Welford and Armstrong, Catalogue 285
Sea-Sickness , 192
Sea-Sickness, Chloral in ... » 24
Sea Water, Gold in 10
Septicaemia 64
Silphium Laciniation 168
Skin, Absorbing Power of the Human 143
Skin Diseases, Treatment of, Surgically Considered . . 76
Skin Diseases, Cases of , 103
IV.
Index.
PAGE
Skin Grafting 1 16
Smith, Dr. Wm. Tyler 216
Snake-Bites, Ammonia in .287
Society, Albany County Homoeopathic Medical . 143, 160
Society, British Homoeopathic .' 119
Society, Connecticut (Allopathic) Medical 268
Society, Homoeopathic Medical, of Penn . 48
Society, Mass. Medical vs. the Homoeopaths 84
Society, Medico-Legal 160
Society, N. Y. Co. Homoeopathic Medical, 210, 234, 259
Society, N. Y. State Homoeopathic Medical, 48, 62,
[66, 70, 144, 207
Society, The Royal Humane 71
Solar, Envelope, Liquid 204
Sore Mouth, Nursing , . . . 95
Spina-Bifida • .... 94
Spleen, Functions of 191
Sponge Tents 94
Starch, Digestion of 237
State Board of Examiners 181
Stricture of the Urethra, New Means of Dilatation in 237
Subcutaneous Injections 248
Sulphitus in Disease . 154
Sultan, Physician to the -. 156
Sumner, Dr. Albert E „ . . 24
Surgery, A System of 283
Surgery, Clinical 126, 152
Surgery, Science and Art of : 137
Surgical Diagnosis, Principle Causes of Error in. . .219
Surgical Operations without Assistance 1 79
Syphilis, Dr. Ricord on 34
Talmudic Gleanings .- 58
Telegraph Co., American District. . . '. 88
Temperature of the Sexes ; 287
Thomas, Dr. T. Gaillard -....* 47
Tic-Douloureux 130
Tobacco Poisoning , 227
Tongueless Speech 215
Tonsillitis, Cured by Baryta Carbonica 287
Tracheotomy, Precautions against Venous Hemorr-
hage in , 192
Tracheotomy Tubes, Substitute for 125
Transfusion 206
Transfusion, A Case of 45
Transfusion of Blood 51' 94
Transplantation of Portions of Skin, Gynecological
Employment of 57
Treitz, Dr 47
Typhoid Fever , 143
Typhoid Fever, Water as a Cause of 144
Typhus Fever, Hydropathic Treatment of . . . 106
u
Ulcer, Chloral as an Application in Fetid : . . 204
Ulcers, Chloral in Venereal 46
PAGE
Ulcers, Chronic 264
Ulcers, New Method of Treatment 23
University, Albany Union 48
University of Berlin 96
University, Boston 96, 232
University, Leipsic 216
University of Michigan 87, 120, 240
University of New York, Med. Dep 48, 71
University of the State of N. Y 192, 232
Urine, Retention of 116
Uterine Diseases, Some Thoughts on 82
Uterine Polypus, Removed from a Child eight years
of age 128
Uterus, A Rapid and Complete Cure of Neuralgia of
the . 199
Uterus, Fibro-Cystic Tumors Treated with Muriate of
Ammonia 10
Uterus, Large Fibrous Tumor of, Treated by Elec-
trolysis 248
Uterus, Treatment of Fibrous Tumors of, by Subcu-
taneous Injections 46
V
Vacations for Doctors 85
Vaccination, Poisonous 91
Variola, Oleum Sinapis Nigri (Sulphi-Cyanalyl) in . . 59
Variola, Perchloride of Iron in 168
Variola, To Prevent Pitting in 120
Vegetable Perfumes, Effects upon Health 132
Veins, Varicose .- . ■ 94
Venereal Affections, Iodoform in . . 116
Verdi, Dr. Tullio S , 115
Verona, Dr .' 24
Veterinary Practice, Homoeopathic Manual of 91
Vienna, A Letter from 32, 107, 159
Vital Statistics from the Ninth Census 105
Von Graefe, Albrecht 202
w
War and Insanity 45
Water, Density of 168
Water, Pure 263
Whooping-Cough, Quinine in 95
Winona, Minn > 55
Woman's Employment 254
World Moves, The 38
Y
Yellow Fever . . ■ .240
z
Zurich, Women Students at 47
Zymotic Diseases, Impure Milk as a Source of 227
THE MEDICAL UNION
A MONTHLY JOURNAL
Of Medicine, Surgery5 and the Collateral Sciences.
EGBERT GUERNSEY, M. D.
JOHN C. MINOR, M. D.
> EDITORS. J
CHAS. E. BLUMENTHAL, M. D.
ALBERT E. SUMNER, M. D.
Vol. I.
NEW YORK, JANUARY, 1873.
No. 1
iDriginai Articles.
MEDICAL UNION.
By A. K. Gardner, M. D.
Is it necessary for me, in commencing an article
in the initial number of a new magazine, one of
whose aims is to re-unite the profession, and to con-
tribute to whose columns I have the honor of being
invited — is it necessary for me to say to my friends,
the profession and the community, that I am un-
changed in belief and practice, differing in no respect
from what I was when a member of the New York
Academy of Medicine, unchanged save in tolera-
tion? What the Christians of Catholic Rome — what
the Protestants of more recent days — what the Pil-
grim Fathers, even, never learned, — respect for the
honest opinions of those who differ; this I have
learned.
Hahnemann and his followers, I believe, looked
only at one side of the shield and saw it to be silver,
while the rest of the profession, from the opposite
stand-point of their fathers, saw it to be golden ; both
were right, but the wrong existed in the want of re-
spect, each for the opinions of the other.
I have not attempted to accurately examine the
claims of homoeopathy, for several reasons. First,
one does not easily, starting with a prejudice, see or
learn new things, and especially at my age, com-
mencing a new half century. Next, it would not be
honest to hold opinions not acted upon, or politic to
change professions, when it might be thought that
such a change was forced, or considered desirable
under the pressure of circumstances. I have there-
fore remained where I was, with my views unchanged
— except in the estimate which I have of those pro-
fessing and practicing homoeopathy. I am free to
confess that the "regulars" do not possess in New
York men of more honesty, respectability, literary
and scientific culture, than are found in the ranks of
the homceopathists, nor can I believe any meaner,
smaller, or more ignorant, can be found among the
"homoeopaths" than among the members of the
New York Academy of Medicine; and I cordially
endorse the professions of the editors of this jour-
nal, whose aim is to unite the factions, and hereafter
to know but one class of men — physicians — edu-
cated, honest and faithful to their duty to heal the
ills of mankind in the best manner that they can.
It seems to me, that in no way can we help this
movement better than by carefully — so far as oppor-
tunities offer — examining and recognizing the dis-
cordant views of the diverse parties. Now, the
statement of Siinilia Similibus Curantur has been
held as an exclusive dogma, and, till quite recently,
has been sustained as the only principle of practice ;
but to-day the advanced and progressive homceo-
pathists hold this not as an exclusive dogma, but as
a fact holding good in many instances.
Till lately, the
"regulars" have denied in toto
it no place in their theories.
this claim, giving
propose to show that this much-quoted saying has
some instances of truth, observed in my own expe-
rience. The meaning of this axiom is, that a medi-
cine which, taken in large (or poisonous) doses, will
produce certain symptoms, when taken in much
smaller and appropriate doses, will cure like symp-
toms of disease. For instance, it is observed by the
homoeopathic practitioners that corrosive sublimate
in large doses causes large, bloody, slimy stools, and
they say that under this law corrosive sublimate in
small doses is the appropriate theoretical remedy for
dysentery, and that, practically, it is a curative one.
Of this statement I know nothing ; but I have some
similar facts of a nature to corroborate these views,
one of which I will briefly give.
Some years ago I had for a patient a woman en-
gaged in house-cleaning, some three to six months
pregnant. While engaged in whitewashing, she so
strained herself that she brought on uterine haem-
orrhage, and a miscarriage was imminent. I ordered
rest, administered some morphine, etc. This checked
all pains and flowing, so long as under their influ-
ence, but they recommenced immediately upon their
being omitted. After some days the woman said
that she could not lay abed any longer, for it was
starvation for her children, and thinking that further
attempt to arrest its coming was useless, I gave her
Tinct. Secale Cornut., in half tea-spoonful doses, to
further stimulate the uterus to expel the ovum. But
what was my surprise to find, with every dose, greater
amelioration of the pains and flow soon entirely
ceasing, so that she went on to full time.
Since that date I have had repeated floodings, ap-
parently threatening abortion, entirely checked by
small doses of the remedy.
Some fifteen years ago, I was called as expert wit-
ness by the defence. A man had been sued for
damages to mother and deformity to child, caused
by his kicking a woman when four months preg-
nant, and in defence he set up that the injury (some
deformity and general debility) was owing to the
mal-administration of ergot by the attending phy-
sician, who had found that the tonic influence of this
The Medical Union.
drug, in small doses, had warded off a threatening
miscarriage, and had enabled her to carry the child
until full time. The defence was not sustained, but
the ergot was deemed properly applied, and its ben-
efit was markedly evident.
EPIDEMIC CEREBROSPINAL MENINGITIS.
By William N. Guernsey, M. D.
Epidemic Cerebro-Spinal Meningitis has been
recognized as a distinct disease during the past
century. Some authors claim that there were epi-
demics of this disease in the preceding one, and
a few endeavor to prove that it prevailed even in
the remote period of the fourteenth century. These
had only imperfect histories of symptoms to base
their statements upon ; and as at that period
various infectious diseases were often confounded
with Meningitis Cerebralis, and when we remember
that in more modern times typhus fever was not
shown to be a distinct disease from typhoid until
1836, we cannot place much credence in their re-
searches.
In the present century there have been four pe-
riods of epidemics. The first commenced in 1805,
and terminated in 18 16; the second occurred be-
tween 1837 and 1850; the third, from 1856 to 1866;
and the last commenced in the winter of 1871 and
extends to the present time.
The first epidemic was of eleven years' duration,
and prevailed in Prussia, Holland, Rhenish Ger-
many, Bavaria and the eastern portions of France.
It was the most extensive in the latter country, and
to the French authors we are indebted for the ear-
liest histories of this disease. In 1806, one year la-
ter than the commencement of the European epi-
demic, cases were first reported in America at Med-
field, Mass. Thence it spread throughout New
England and Canada, and a few cases also occurred
at the South and West.
The second epidemic commenced in 1837, and
lasted about thirteen years. It was severer and far
more extensive than the previous one. For the first
two years it was limited to France, and then ex-
tended to Italy and Algeria, and until 1850 these
countries were not free from it In 1849 it visited
Spain.
Also, the disease designated and described by Dr.
Robert Mayne as Cerebro-Spinal Arachnitis, which
broke out in the work-houses in Dublin, in 1 846,
was probably identical with the epidemic prevailing
on the Continent.
In 1842, it broke out in the south-western States
of the Union, and afterwards prevailed simultane-
ously in isolated places there, at the West, and in
Pennsylvania and New York.
From 1850 to 1854 this disease ceased to be heard
of, when suddenly the third epidemic commenced
with unusual severity in the south of Scandinavia,
and during the next six years it extended to the
northern portion. In i860 it broke out in Holland,
and in 1863 in Northern Germany, which had
hitherto almost completely escaped this epidemic.
Here it spread very widely, and lasted until 1866.
About the same time cases were reported in Rus-
sia, in Ireland, and a few isolated ones in England
— although in the latter country it has never pre-
vailed epidemically.
In our own country it first manifested itself at
this period in the winter of 1861-62, amongst our
troops, stationed in Virginia and in Missouri. It
recurred the three succeeding winters at portions
of the South, and in some of the hospitals at the
North.
About the beginning of the present year it broke
out epidemically for the first time in New York,
although isolated cases of spotted fever were re-
ported in 1 87 1. It prevailed quite extensively
during the winter and spring, and also in sections
of this State and in Pennsylvania.
The first series of recognized cases reported to
our Metropolitan Board of Health were on the 6th
of January. From then to May 31st, there were
632 cases reported to the City Sanitary Inspector,
and 469 deaths to the Bureau of Records. Un-
doubtedly, many more cases occurred which failed
of being reported, as many physicians were at first
not familiar with the disease, nor cognizant of the
necessity of reporting cases to the Health Board.
The most common synonyme of this disease is
spotted fever, which was given to it by the physi-
cians of this country during the first epidemic here.
Another is petechial fever. North, in 1809, desig-
nated it the malignant spotted fever, and Lyons,
the black fever, which is still a popular name for it
in some localities. All of these seem quite inap-
propriate, as the eruption is often wanting, and
they convey no idea of the nature of the disease.
Little is known of the kind of the poison from
whose pernicious influences emanated these epi-
demics that usually occurred simultaneously in lo-
calities far remote from one another. That there
is not simply an idiopathic inflammation of the
cerebro-spinal membranes, the anatomical appear-
ances clearly prove, as in the suddenly fatal cases
often but little pathological changes are apparent.
Many writers have endeavored to trace the cause
to excessive cold, as most epidemics have occurred
in the winter season. Mannkopf, of Berlin, how-
ever, says that the average temperature of the
months in which the epidemic prevailed, was not
below that of corresponding ones in many preced-
ing years.
That it may be dependent upon a miasmatic
poison, is suggested from the extension of the epi-
demic to places not contiguous to each other. Yet,
the localities themselves have afforded no clue to
the nature of the poison.
The mountains, the plains, the dry, arid spots,
the well-watered verdant valleys, and the humid
marshes, are all alike frequented by this disease.
It visits city as well as country, and stalks alike
in palatial residences, and dirt-begrimed hovels.
Salubrious mountain villages are often as severely
stricken as the badly-drained, filth-reeking portions
of some of our cities.
In our recent epidemic, a very large proportion
of the cases have been reported, however, from the
poorer wards of the city, and our Health officer
says, in his report, that wherever the ■ local condi-
tions have been carefully examined, it has been
found that the drainage of the premises has been
faulty, or that the immediate surroundings have
presented such conditions as must necessarily give
rise to some form of disease. He deduces from
his observations that there can be no doubt that,
overcrowding, with its attendant evils, accumula-
tions of ordure, refuse, and various kinds of filth,
The Medical Union.
absence of a proper supply of pure, fresh air, and
personal neglect, invite and aggravate certain epi-
demic tendencies ; and consequently we find, on
examination of a map indicating the localities where
cerebro-spinal meningitis has prevailed, that the
largest proportion is to be found where these con-
ditions obtain.
Yet, in many of the European epidemics, no
intimate relation existed between filth, poverty,
immorality and absence of good hygienic condi-
tions, and the outbreak or extension of this disease.
Viesseaux says, that in Geneva it attacked, equally,
all ranks, both rich and poor; those in narrow,
dirty and crowded rooms, and dwellers in man-
sions, who were sole occupants of spacious and airy
chambers. Mannkopf observed the same conditions
in the epidemic in Berlin. The French speak of
its greater prevalence amongst the well nourished,
and those living under favorable sanitary condi-
tions.
Although from reviewing the histories of past
epidemics, cold, want, dissipation and vice cannot
be classed together as exciting causes, yet they
undoubtedly prepare a fertile ground for the recep-
tion of the seeds of this as of other epidemic dis-
eases.
During the past winter, small-pox was epidemic
here and throughout the Middle States. It spread
widely, and was unusually fatal. Also typhoid fever
was rife, and typhoid symptoms complicated nearly
every inflammatory condition. Malignant scarlet
fever and pneumonia, of an asthenic type, were
unusually prevalent.
The winter was very severe, and there was only
a slight fall of snow.
Although the disease is not directly traceable to
atmospheric or telluric influences as exciting causes,
yet its concomitance with other epidemics of an
adynamic character, leads us to suppose that the
specific poison of the disease is only engendered at
those periods when zymotic diseases are widely
prevalent and highly fatal. To what derangement
of the vital stimulants are due these depressing
periods ?
Dr. Knapp, of Mexico, has recently brought for-
ward the theory that the periodical increase of
planetary attraction, which occurs when the supe-
rior planets make their perihelion circuits, is the
cause direct and indirect of the inauguration of
epidemics, or recurrence of the so-called pestilential
periods.
He writes, if the sun and moon disturb earth,
ocean and atmosphere, by their force of attraction,
elevating immense tidal waves thereon, with in-
crease of gravity in the atmosphere appreciable
by the barometer, and if the mass of Jupiter is by
far the most influential element in the planetary
system after that of the sun, and Saturn the next,
surely Jupiter's and Saturn's periodical approaches
in making their perihelion circuits must affect the
earth and the organized existences on its surface to
a considerable extent or degree, by their increased
attraction of gravitation and disturbance of its at-
mosphere, and the natural vital stimulants of all
organized life.
The blights in vegetation, which invariably pre-
cede and accompany epidemics, he attributes to
the derangement of the usual supply of the stimu-
lus furnished by gravity, and asserts that the pesti-
lential periods are always coincident with the
perihelia of the large superior planets, especially
of Jupiter and Saturn.
According to his illustrations, the gravity of the
first epidemic coincided with the perihelion of Ju-
piter in 1809 ; that of the second, with the com-
mensurate perihelia of Jupiter and Saturn, which
coincided also with the ship fever epidemic of the
Irish famine years, from 1845 to 1849, when they
culminated in cholera. Our last epidemic would
have coincided with the perihelion passage of Ju-
piter in 1868, and as he is about six years in making
his perihelion circuit, his influence would be dis-
tributed over that time.
In giving Dr. Knapp's theory, I would not infer
that I fully subscribe to it, but think it quite plausi-
ble ; and as we have hitherto confined our almost
fruitless researches for the causes of pestilential
periods to objects around us, it would be well to
study the effect of planetary attraction upon the
growth and welfare of terrestrial organisms.
The disease usually strikes the robust and strong
in preference to the effeminate and sickly. Males
are generally more liable to it than females ; in
Massachusetts and in France the percentage of the
former, who were attacked, was fifty greater than
the latter. In some epidemics the majority of the
sufferers were children, in others both children and
adults were affected.
It is met both in civic and military life ; in some
countries having been limited almost exclusively
to the army, and in others, again, the civic classes
have been the only sufferers.
Post-mortem: — In recent cases there is no emacia-
tion of the body, and rarely cadaveric rigidity of
the muscles. Suggilations are absent, and, ex-
cepting the remnants of herpetic or petechial
eruptions, there is rarely any discoloration of the
skin. In protracted cases emaciation is extreme,
and the skin is dry and scaly.
The scalp is vascular, and the cranial bones
are often injected. The dura mater cerebri is
injected, and sometimes tensely stretched. The
longitudinal sinus is filled with dark fluid blood.
The dura mater of the spine is also generally vas-
cular, more often tense than that of the brain, and
its sack frequently contains a serous effusion. Sel-
dom is purulent matter found mixed with it. Fre-
quently the dura mater is adherent to the pia,
either in points or over a considerable extent. But
the pia mater of both the brain and the cord is the
seat of the most extensive changes. It is always
hyperaemic, sometimes dry, and is the seat of an
exudation, which forms the most prominent and
characteristic pathological condition.
This exudation takes place principally at the base
of the brain, and on the posterior surface of the
cord. It does not cover the latter uniformly alike,
but is greatest either at the cervical portion or on
the canda equina. In the earlier stages of the
lighter forms there is subarachnoideal serous effu-
sion containing flocculi of lymph and pus cells. In
severer cases, the exudation is cloudy, grayish, and
of a gelatinous consistence. In the severest forms,
pus is freely poured out, and forms thick masses of
firm consistence, and although most abundant at
the base, the whole surface of the brain participates
in the inflammation, presenting in its different parts
all the various stages.
Thus, when at the base, the changes are such as
were last described ; the sides are clouded or of a
The Medical Union.
light yellowish color, and the convexity is dry and
hyperaemic. The exudation penetrates into the
fossa sylvii, and is very abundant about the chiasm.
It is present also on the anterior surface of the
spinal cord, although to a much less degree than
on the posterior. In long protracted cases there
is comparatively little purulent exudation ; but the
pia is relaxed and greatly thickened. The exuda-
tion is midway in nature between the pure purulent
exudation of simple meningitis and the sero-puru-
lent of the tubercular form.
Most authors say that the purulent exudation is
always present at the basis cerebri in rapidly fatal
cases; the meningite fondroyante. It has been de-
nied by a few, and they claimed its absence denoted
an intensely powerful infectious poisoning of the
system.
Microscopical examination shows a proliferation
of the connective tissue cells in the pia, and in the
tunica adventitia of the arteries.
The brain substance and the spinal cord are
hyperaemic — in the former both gray and white
substance are highly vascular, and the white por-
tion is dotted with points of injection, and fre-
quently of red softening. The lateral ventricles
are frequently distended with a reddish colored
serum. The roots of the nerves are surrounded
by the infiltration, and on microscopical examin-
ation, we find in the surrounding connective tissue
an extensive growth of cells, which penetrate be-
tween the bundles of nerve fibres separating them
from each other.
The muscles are of a dark brown red color. The
heart is relaxed, often of a grayish yellow color,
and sometimes shows, microscopically, fatty degen-
eration. The lungs are commonly hyperaemic,
and evidences of cedema or broncho-pneumonia
are often present.
Most writers speak also of a hyperaemic condi-
tion of the intestinal canal, especially of the peye-
rian patches ; but as calomel and other cathartics
were generally liberally given during the course of
the disease, it was probably induced by the treatment
adopted. The liver and spleen are often softened,
and the latter is frequently enlarged. In all cases
the kidney is injected, and its cells clouded.
In no other disease, perhaps, do the single cases
present such varied and strongly contrasting pic-
tures of symptoms which often confuse the physi-
cian, and, as in the Ketchum poisoning case, place
them unfavorably before the laity. Many authors
have made many divisions and subdivisions of the
disease ; but I prefer simply three, classifying the
very acute cases under meningite fondroyante, and
the lightest under the abortive.
The disease is ushered in by a chill and a violent
headache, which is frequently accompanied with
vomiting.
The chill is of variable duration, often repeated,
and followed by a fever of moderate intensity. The
headache is persistent, and the pain soon extends
to the neck and spinal column. The spine becomes
exceedingly sensitive to pressure. Early the head
is drawn backwards, the muscles of the neck be-
come stiff, and frequently opisthotonos occurs. The
mind is ordinarily clear until now, when it gives
way to delirium, which, in severe cases, soon yields
to coma.
The pulse is frequent, but not so rapid as in the
infectious diseases. The temperature is only slightly
elevated, never rising higher than 1030, Fahrenheit.
There is slight increase of thirst, and at first loss
of appetite. The eyes are occasionally suffused,
and the pupils generally contracted. Deafness of
a variable degree is quite common. The face is
usually slightly suffused, and presents an apathetic
or anxious look. Slight bronchial catarrh is gen-
erally concomitant. The abdomen is sunken, and
in grave cases its surface has a canoe-shaped ap-
pearance. Obstinate constipation is almost always
present ; and, as the derangement of the sensorium
occurs, the urine is retained or involuntarily emitted.
Severe neuralgic pains are common in the ex-
tremities and are due to the irritated condition of
the posterior roots of the spinal nerves. Herpetic
or petechial eruptions frequently appear — the for-
mer around the mouth, on the cheeks or on the
ears, and the latter upon the trunk.
The symptoms increase in severity until the acme
of the disease is reached, and after a variable period
of time convalescence commences, which is slow,
protracted, and liable to many variations. Relapses
are frequent, and often terminate fatally. The
disease has no day of crisis, and is variable in du-
ration. In meningite fondroyante they die within
the first two days, and frequently within a few hours.
In these rapid cases many of the objective symp-
toms are wanting; the tetanic spasms may be
absent, as the patient dies from general paralysis.
In cases of moderate intensity, there is frequently
an abatement of the severity of the symptoms at
the end of the first week or during the second ; but
convalescence may be protracted.
Authors speak of an intermitting form. In our
last epidemic it occurred frequently either in the
first stages or during convalescence. In the for-
mer variety it generally assumes a quotidian type,
the symptoms persisting more or less clearly during
the greater portion of the day, yet are followed by
complete remissions. After continuing thus a few
days the remissions cease, and the disease becomes
more violent. Quotidian exacerbations of variable
severity occasionally occur during convalescence,
prolonging the disease greatly. Death usually re-
sults in the early stages either from asphyxia or
general paralysis, and in the protracted cases from
marasmus.
In order to present a more complete history of
the symptoms, I will speak of them singly, and
mention their chief peculiarities.
The headache is the most prominent and dis-
tressing symptom. It is always present, excepting
in the fondroyante form, where the disease suddenly
overwhelms the patient, and he passes off in coma.
Patients speak of it as a boring, throbbing pain,
extending over the whole head, but most severe in
the occipital region. Even in coma it is probably
present, for the patient, with an anxious, suffering
look, tosses his arms, and points and strikes con-
tinually at his head.
The delirium is variable. Frequently it is low
and muttering, at other times the patient talks
excitedly, and in an incoherent manner. During
the day the intellect is often clouded, the patient
only answering questions when aroused, and re-
lapsing immediately afterward into a stupid condi-
tion. At night this yields commonly to delirium.
Another common symptom is the pain in the spinal
column. Patients complain of a full, tense feeling,
and a burning pain in the cervical portion, and fre-
The Medical Union.
5
quently, also, in the lumbar region. It does not
usually appear until the second or third day of the
disease. It is increased by pressure upon the spine,
and aggravated by motion of it. The nodding of
the head is especially painful, and even in the
lightest forms the patient refrains from it.
Hyperassthesia of the skin is often present in the
early stages. The sensitiveness of the patient to
being touched or handled, affords an important
diagnostic sign in differentiating this from infec-
tious diseases. Anaesthesia occurs rarely while the
intellect is unclouded. It is supposed to arise
from the loss of sensibility of the posterior roots
of the nerves as a result of the inflammatory
changes.
Groups of muscles are commonly highly sensi-
tive also in the first stages of the disease. The
muscles of the neck and back are most frequently
affected, and often those of the extremities.
The tetanoid phenomena are generally present
in all cases, and occur early in the disease. Al-
though indicating inflammation of the spinal men-
inges, their absence is no proof that inflamma-
tory changes do not exist. The head is firmly
drawn back upon the neck, and the back is curved,
producing marked opisthotonos. The patient lies, in
consequence, upon the side, or frequently, in marked
cases, upon the abdomen. Clonic spasms are some-
times present. Paralysis of some of the muscles
of the eye occasionally occur, but rarely the ex-
tremities are affected. The obstinate constipation
which is universally present, and the frequently oc-
curring retention or incontinence of the urine are
due to disturbances of the motor nerves.
Patients not unfrequently become blind from
purulent choroiditis, probably arising from metas-
tasis. Dr. Knapp says this affection begins usually
in the first week of the disease, and that the sight
is generally lost.
Deafness is remarkably frequent, and arises, in
all probability, from a purulent inflammation of the
labyrinth, by which the membranes of the inner ear
are destroyed in a similar way as the membranes
of the eye, by the purulent choroiditis.
The symptoms presented by the digestive organs
are not prominently marked. The tongue is com-
monly covered with a creamy-like fur, and is some-
times reddened at the edges. Sordes never form to
any extent. The appetite is commonly wanting
at first, but later on there is often an unnatural
craving for food. Vomiting occurs at the out-
break of the malady, and frequently during the
latter stages. It arises from the disturbed condition
of the brain, and is excited rather by motion of the
body than by presence of food.
The urine is variable in quantity, usually less
than normal, and often contains traces of albumen
and a few epithelial casts. In some cases, the joints
are swollen and inflamed, the knee being most fre-
quently affected.
As a consequence of the bronchial catarrh, the
breathing is labored and rapid, and when the te-
tanic symptoms are strongly marked, the respira-
tion is much oppressed.
The eruption is not always present. European
authors speak only of its occasional occurrence.
American writers vary as to the ratio of cases in
which it appears. Stille, of Philadelphia, says that
62 per cent, of the cases under his observation had
eruptions of some sort.
In our recent epidemic it was frequently present,
but not in the majority of the cases.
I have met with the herpetic and petechial varie-
ties only ; but in previous epidemics the exanthema-
tous and urticarial were also frequently seen.
The fever varies greatly in intensity and duration.
The temperature is generally only slightly elevated,
and presents no regular curves as in the infectious
diseases. Generally it ranges from 990 to 1020,
and in fatal cases it may reach 103^. The pulse is
weak, feeble and thready, and does not correspond
to the temperature in frequency. Often, it is re-
tarded, and sometimes falls below its normal con-
dition. When convalescence occurs it does not
approach the healthy standard so rapidly as the
temperature.
This disease has often been confounded with
typhus and malarial fevers. If the difference of
the anatomical appearances of cerebro-spinal me-
ningitis and of typhus is kept distinctly in view,
the symptoms of inflammation of the meninges
will be rarely confounded with those of the latter
disease.
In cerebro-spinal meningitis there is the severe,
throbbing darting headache, characteristic of me-
ningeal inflammation; in typhus it is dull and
heavy. In the former disease, delirium, when
present, occurs early ; in the latter, not until the
headache commences to subside, and rarely before
the end of the first week. In the first disease the
eruptions are not constant, and appear on the first
or second day ; in typhus, not until between the
fifth and seventh. The meningitis is not conta-
gious, the typhus highly so.
Cerebro-spinal meningitis occurs in all ages, but
more frequently in children, while typhus is almost
exclusively limited to adults. In one, we have a
moist tongue, persistent vomiting, tetanic spasms
and hyperassthesia. In the other, the sordes, trem-
ulousness and blunted sensibility are characteristic.
The pulse, temperature, course and duration of the
two diseases vary greatly.
Between epidemic cerebro-spinal meningitis and
malarial fever, the vomiting, the low temperature,
the hyperassthesia, the eruption, the pain along the
spinal column, and the utter failure of quinine in
arresting the intermittent symptoms will differen-
tiate the former disease from the latter.
The prognosis varies according to the type of
the epidemic, and with the period of each. At
the commencement, the meningite fondroyante is
frequent ; in the latter part, the abortive.
In the epidemic of Germany from 1862 to 1866,
the mortality ranged from 40 to 55 per cent., and in
some of the earlier ones it reached as high as 80 per
cent. In our city hospitals 30 per cent, have died.
It is difficult to foretell the result of any case, as many
commencing with light symptoms often end fatally,
while those ushered in with all the graver phe-
nomena frequently recover. After convalescence
seems well established, there are frequently fatal
relapses. We may consider as unfavorable symp-
toms, great depression, sudden coma, jactation, re-
appearance of protracted vomiting, and the pe-
techial eruptions. Cases occurring among chil-
dren and the effeminate, afford a better prognosis
than those among the strong and robust.
I now enter, with pleasure, upon the consideration
of the treatment of this disease. We have seen that
under allopathic treatment the ratio of deaths has
The Medical Union.
never been less than 30 per cent. I have taken
much pains to obtain statistics of the mortality of
this disease under homoeopathic treatment, and the
result of my researches shows that less than 1.0 per
cent, of our cases end fatally.
Our allopathic brethren rely principally upon
cold applications to the head and spine, and opium
in massive doses to quiet the delirium, relieve the
headache and remove coma. Some use, recently,
bromide of potassium instead of opium. Calomel
and iodide of potassium are frequently given.
Our treatment has been in the forming stage,
cold applications to the head and nape of the neck,
and the administration of gelseminum alone or with
belladonna internally. If the disease assumes a
sthenic, inflammatory type, we have substituted
aconite for the gelseminum. As soon as the spinal
symptoms appear, we alternate secale with gelse-
minum. To relieve the coma, we rely upon opium.
Even our allopathic friends regard opium as their
sheet anchor, and have gone so far as to call
it a specific for this disease. They speak of it " as
a most powerful agent in removing the deepest
comas which were not absolutely irrecoverable,"
and recognizing its efficiency in the treatment of
one symptom, give it empirically for all. Conium
acts favorably in relieving jactation. For promot-
ing absorption, mercurius biniodide is deservedly
a favorite remedy.
In the long protracted cases, where emaciation
is extreme, phosphorus and nux are serviceable.
In these cases inunctions of cod liver oil are highly
beneficial. The purulent choroiditis and the deaf-
ness are irremediable.
No. 18 West 23^ Street, N. Y.
RESECTION OF THE INFERIOR MAXILLA,
FOLLOWED BY COMPLETE*REPRODUC-
TION OF THE BONE.
A CASE OF ACUTE NECROSIS FOLLOWING THE USE
OF ARSENIOUS ACID FOR DENTAL PURPOSES —
MERCURIAL SALIVATION PRODUCED BY AN
AMALGAM FILLING.
By John C. Minor, M. D.
On the 10th of February, 1871, I was called to
attend the case of Mrs. B. She was 27 years old, a
widow, and her health, prior to her present illness,
had always been excellent. The most careful ex-
amination showed her to be entirely free from scrof-
ulous or syphilitic diseases, either hereditary or
acquired. I found her in bed too much prostrated
to sit up, her complexion sallow, expression anx-
ious, pulse 120 and weak, the perspiration stand-
ing out in great beads on her forehead, her face
swelled and her body emaciated. She was pro-
fusely salivated, her breath was horribly offensive,
and an attendant was constantly occupied in wiping
away the secretion that streamed from her mouth.
An examination of the mouth revealed necrosis of
nearly the entire lower jaw. Nearly all the teeth
had fallen out or been removed ; the tissues around
the jaw were thickened and vascular ; the parts ad-
jacent were bathed in foetid pus that constantly
exuded from the sockets, and a probing of the bone
revealed an extension of the necrosis from the articu-
lation on the left side to a point within an inch-and-
a-half4 of the articulation on the right side. Her
strength was rapidly failing and her condition a most
unfavorable one for the success of any operation ;
but I nevertheless advised an immediate removal of
the bone as the only chance of saving her life, and
this opinion was concurred in by the attending phy-
sicians. Accordingly, upon the following day, Feb-
ruary nth, 1871, I removed the jaw. Drs. T. F.
Allen, F. E. Doughty, Belden, Jernegan, Allan and
Fitch were present, and rendered valuable assist-
ance.
Operation. — The patient was placed in an occu-
list's chair and chloroform administered. When she
was fully under its influence, I drew the tissues for-
ward from the neck upon the bone, so that the re-
sulting scar should be hidden behind the folds of the
cheek and chin, and then, with a few rapid strokes
of the knife, I divided the tissues down to the bone.
This first incision began about half an inch in front
of the articulation on the left side, and then followed
the inferior border of the bone to the symphysis
menti. The hemorrhage was controlled by pressure
alone, the facial artery being of such small size that
no ligature was required. My second incision was
simply a prolongation of the first, extending it, as be-
fore, along the inferior border of the bone to a point
an inch below the articulation on the right side. At
this point the knife struck a smoother surface of bone
and I stopped my incision where the disease seemed
to have terminated. The right facial artery was
now seized and tied, and I proceeded to separate the
dead bone from the periosteum and surrounding tis-
sues. This was done, as far as possible, on both
sides before the muscular attachments of the tongue
to the symphysis were disturbed. A ligature was
now passed through the tip of the tongue and given
in charge of an assistant, and the muscles of the
tongue divided at their point of attachment to the
bone. A chain saw was immediately passed around
the bone, and section made through the middle of
the symphysis. A considerable quantity of foetid,
grumous pus immediately followed this section, pour-
ing out of the dental canal which had been filled
with the matter.
Grasping the left half of the bone with the lion
forceps and using the handle of my knife, the bone
was readily enucleated from its investing periosteum,
and a slight twist disarticulated it so that the liga-
ments were easily divided by the blunt scissors, and
the bone removed. The coronoid process broke off,
however, during these manipulations and immedi-
ately retracted. I seized its lower border, removed
all I could get away with the gouging forceps and
allowed the rest to remain. The right side of the
jaw was now attacked in the same manner ; the ra-
mus divided with the chain saw, an inch-and-a-half
below the articulation, and all below the point of
division brought away. A considerable collection of
pus was detected in the left side of the neck, bur-
rowing its way down behind the platysena ; this was
evacuated by a free incision from without. The
wound was now carefully cleaned, and an examina-
tion showed the periosteum to have been most care-
fully preserved. Silver sutures were used to unite
the edges of the wound, and a hare-lip pin was in-
serted so as to hold the muscular attachments of the
tongue in position. A dressing of soft tow was ap-
plied ; this was supported in position by a bandage
passing around the patient's head, and she was then
placed in bed with a trusty nurse stationed beside
The Medical Union.
her in charge of the ligature that held the tongue
forward in its position.
Subsequent History. — In twenty-four hours the
ligature through the tongue was removed, the adhe-
sions having become sufficiently strong to hold the
part in position. The patient did not rally well.
For several days she was more or less delirious. The
forehead was constantly bathed in perspiration, her
pulse continued about 120 and very weak, and there
was no immediate abatement of the feverish symp-
toms. The urine was scanty but not albuminous.
The ptyalism continued as before the operation.
Her condition seemed rather worse than before the
operation, for the same general symptoms were pres-
ent, and surgical shock was superadded to these. I
gave her large inhalations of pure oxygen gas. Dis-
carding the bags ordinarily used for the purpose, I
attached one end of the tube directly to the receiver
of compressed gas, and placing the other end in her
mouth, I turned on the gas so that a gentle stream
should flow through the tube. These inhalations
were repeated every two or three hours, and the tube
was allowed to remain in situ for half an hour at a
time. In addition to this, chlorate of potash was
administered internally, and used as a wash for the
mouth. The patient was carefully nourished and
moderately stimulated. At the end of a week there
was a decided improvement in her condition. The
mind became clear, the skin more natural in color,
and the hectic fever subsided. Most of the sutures
were removed on the sixth day, the incision having
healed, for the most part, by first intention. During
the second week the ligature around the facial artery
came away and the remaining silver sutures were
removed. The inhalations of oxygen gas had been
gradually diminished in frequency, and were now
discontinued.' Syrup of the hypophosphite of lime
was alternated twice a day with small doses of chlor-
ate of potash. During the third week I passed a
probe through a small fistula on the right side, and
detected necrosis of the free extremity of the ramus.
I therefore dilated the fistula so that I could seize
the dead portion with forceps, and as it was perfectly
detached, I brought it easily away. It proved to be
an exfoliation of the free extremity of the right ra-
mus, about half an inch long, resembling the thim-
ble-shaped exfoliations occasionally met with after
amputations. After this the patient steadily recov-
ered her health and strength, and a new jaw began
to form, appearing at first as a cartilaginous deposit
shaping itself into the form of the old jaw. This
new formation became gradually harder, and as it
increased in firmness the muscles began to exercise
their control over it. Finally, after a period of six
months, the new jaw became dense and solid, com-
pletely under muscular control, perfect in its shape,
free and natural in its motions, and differing from
the old jaw in containing no teeth and in being
somewhat smaller in its dimensions. The last traces
of the ptyalism disappeared about two months after
the operation. A few weeks ago she called upon
me, and I was surprised to find how few traces had
been left of the operation. The scar was completely
hidden from view, and even a critical examination
failed to detect the extent of the incision, so perfect
was the union of the parts. The chin was some-
what retracted, owing to the new jaw being smaller
than its predecessor ; but this retraction was not to
such a degree as to produce deformity. On opening
the mouth a full set of teeth appeared — artificial
ones — that had been fitted to the new jaw by Dr. N.
W. Kingsley. To the ordinary observer, there was
no evidence that this patient had ever lost her jaw,
so completely had nature and art repaired her loss.
Previous History. — The previous history of this
case is, in some respects, more remarkable than the
operative results, and suggests some questions of
peculiar pathological interest. This bone which I
removed, on the nth of February, was apparently
sound on the 1st of January, and even on the 7th or
8th of January it was not supposed to be seriously
threatened. And yet on the 27th of January the
bone was dead, and had probably been so for some
time. It is safe to say that this extensive necrosis of
the bone occurred within a period of two weeks, an
exceptionally rapid progress even for acute necrosis
to make. The application of arsenious acid for the
purpose of killing the nerve, upon the 27th of De-
cember, was followed by an exfoliation of bone in
front of the tooth that was recognized on the 7th of
January, and on this latter date another application
of arsenic was made, and in less than two weeks the
jaw was dead. Now, a slight exfoliation of bone, re-
sulting from the use of arsenious acid, is not an
uncommon occurrence in dental practice, — most
dentists, at least, have seen such cases, — nor is it
usually considered of much importance, but in this
case it acquires a remarkable interest, because the
question at once arises whether the action of the
arsenic stopped there; — whether, in fact, the agent
employed to kill the nerve did not also kill the jaw.
This question becomes more significant when we
find so careful an observer, and so weighty an au-
thority as Dr. J. Mason Warren, of Boston, record-
ing two similar cases of extensive necrosis of the
jaw produced by the use of arsenious acid for dental
purposes. We find again that, on the 8th or 9th of
January, while the parts around the tooth were in-
flamed and vascular, an amalgam filling was inserted
into its cavity, and in less than ten days the patient
was salivated to such a degree that the ptyalism
continued for more than two months afterwards.
Let us now examine the record of this case prior to
the operation :
Dec. 29, 1870. — Mrs. B. had a decayed tooth, the
second molar on the left side of the lower jaw, that
had given her occasional pain. On the 29th of
December, while suffering from tooth-ache, she
called upon her dentist in Poughkeepsie, where she
lived, and desired him to kill the nerve and fill the
tooth. The dentist, after examining the tooth, ad-
vised its extraction, but finally deferred to the
wishes of his patient and applied a minute quantity
of arsenic to the nerve in the usual manner.
Dec. 30. — The pain still continued but not se-
verely. The dentist removed the arsenic, made an
application of kreasote to the cavity and directed
the patient to call again the next day.
[Had she followed the instructions of the dentist,
there would have been no trouble. His first advice
was sound, and he was perfectly competent to treat
even the subsequent exfoliation that occurred. In-
stead of calling again the next day, as she had been
directed, the patient resolved to come to the city
and spend the holidays. She accordingly came to
the city and received calls on New Year's Day,
although she was suffering at the time from "severe
toothache. "]
Jan. 4, 1 87 1. — The pain in the tooth continued
without any material change since the last date.
8
The Medical Union.
On the night of January 4, while returning from the
opera, the patient was for a short time exposed to
the weather, so that she became wet and chilled.
[I mention this exposure to wet and cold because
it is one possible cause of necrosis. At the same
time I do not hesitate to exclude it as one of the
possible causes of this necrosis. In reviewing a
pretty extensive experience of this disease, I have
yet to meet with the first case of necrosis from this
cause except where the disease has been located in
the bones of the lower extremity; and, furthermore,
I have thus far failed to discover a recorded case
of any bone higher up than the humerus, whose
death can be attributed to exposure to wet and cold,
unless the patient had been at the time of exposure
under the influence of mercurials, a condition which
was wanting in this case* Markoe gives the gen-
eral experience of surgeons in this particular when
he says: " The bones most liable to suffer are those
most liable to direct exposure to the injurious cause,
as the bones of the feet and the shaft of the tibia.
It would seem, also, that the exposure must be pro-
longed, in order to produce its effect, * * * suffi-
ciently to act as an exhauster of the general power
of resistance, as well as a depressor of the local
circulation of the part about to be affected." — {Dis-
eases of the Bones, p. 122.]
Jan. 7th. — The pain in the tooth had now in-
creased to such a degree that the patient concluded
to have it out. She accordingly called upon a den-
tist in this city, who found, on examination, that a
portion of the anterior wall of the socket had exfo-
liated, and he informed the patient of that fact. He
did not consider the trouble as of serious import-
ance, and persuaded the patient to have the tooth
filled. As the nerve in the anterior fang of the tooth
was still alive, he reapplied arsenic in order to de-
stroy it. The part was very sensitive to press-
ure. .
[The total necrosis had not yet begun. The
slight exfoliation discovered on the 7th inst. was
probably due to the arsenic applied on the 29th of
December. Its extent, however, was not so great as
to prevent another dentist from making the same
application in order to destroy the remaining por-
tion of the nerve. The persistence and severity of
the pain points, however, to a deeper seated trouble
than mere tooth-ache or a superficial exfoliation of
bone, and there can be no doubt that the symptoms
were those of periostitis attacking the membrane
lining the socket of the tooth, or at least confined to
the immediate locality of the tooth. We may as-
sume, then, on sound pathological grounds, that this
patient was, on the 7th of January, suffering from an
inflammation of the periosteal membrane, in the
immediate vicinity of the second molar tooth on the
left side of the lower jaw, that had not yet arrived at
the stage of suppuration, but was in a state of hy-
peremia, just balancing between resolution on the
one hand and an extension of the disease on the
other. Had the tooth been extracted then, it is
probable that a complete subsidence of the symp-
toms would have resulted. A slight irritation of the
part, however, would be adding fuel to the fire, and
must inevitably turn the scale the wrong way. The
tooth was not extracted. Arsenic was inserted into
its anterior fang. Now, if one kind of violence will
inflame a part, the same violence repeated will kill
it; if a chemical agent, an escharotic, for instance,
like arsenious acid, will produce severe inflamma-
tion, the same repeated will destroy the part. This
is true of all external exciting causes of inflamma-
tion, because the repetition of the irritation is made
to an affected part whose vital forces are already de-
pressed.]
Jan. Sth. — The parts immediately around the
tooth had now become exquisitely tender and pain-
ful. The dead nerve was removed, and the cavity
filled temporarily with cotton and sandrac varn-
ish.
Jan. gth. — The tooth was filled with amalgam.
"I never suffered such intense agony," said the pa-
tient to me when relating her case, "as that pro-
duced by the filling of my tooth. It was hor-
rible."
A period of intense suffering now began that was
terminated by the removal of the jaw. So great
was the pain, and to such an extent were the mind
and body of the patient prostrated, that I could
never get from her a clear account of the case dur-
ing this eventful period. I have ascertained, how-
ever, that the tissues surrounding the bone became
rapidly swollen, hot, and always painful. Hectic
fever set in, and the patient became profusely sali-
vated. A physician was called in (Jan. 17 th), who
applied hot poultices to the face and administered
saline cathartics. The teeth now became loose, and
pus began to ooze from their sockets. The patient
was prostrated with fever; her appetite and strength
rapidly failed, and she was at times delirious. The
attending physician was dismissed, and Dr. T. F.
Allen called to the case (Jan. 27th). The doctor
called in the services of a competent dentist, and
after lifting out some of the teeth — no forceps were
required — the parts were thoroughly syringed, and
an examination made of the condition of the jaw.
It was found to be extensively necrosed, the necro-
sis involving the whole thickness of the bone and
nearly its whole extent. Under Dr. Allen's care
every effort was made to support the failing strength
of the patient and favor the separation of the dead
bone from the living; tissues. But the thing was im-
possible. The patient's strength was so far exhaust-
ed that she failed to respond to the means employed.
It became at last a question as to what should be
done to save her life, for it was evident that septi-
caemia would bring the case to a speedy and fatal
termination, unless some more radical treatment
should succeed. Under these circumstances I was
called to the case, and removed the dead bone, as al-
ready described.
The history of this case prior to the operation is
remarkable for three things — First, the cause of the
necrosis; secondly, the rapidity of the disease;
thirdly, the occurrence of mercurial salivation. The
case demands a fuller investigation, because its re-
lation to the ordinary practice of dentists, as regards
the use of arsenious acid for killing the nerves and
amalgam for filling the cavities of the teeth, is of
the utmost importance.
I shall therefore consider the pathology of this
case in a more thorough manner in a future article,
merely premising that consideration with the state-
ment that there was no history or evidence that my
patient ever suffered from any form of scrofulous or
syphilitic disease, and that there was no mercury ad-
ministered to the patient except in the shape of an
amalgam filling.
10 East \\si Street, N. Y.
The Medical Union.
LARYNGEAL PHTHISIS.
By E. J. Whitney, M. D.
In no direction, perhaps, has the application of
Laryngoscopy been of greater service than in the di-
agnosis of those conditions of the larynx which, al-
though manifesting themselves during the course
of Pulmonary Tuberculosis, may, or may not have
any connection with it. Until a comparatively short
period, it was generally believed that all morbid
laryngeal conditions in Tuberculous subjects were
identified with, or bore a direct relation to, the dis-
eased condition of the lungs, and extended by the
same pathical process over the mucous membrane
and sub-mucous tissue of the larynx and trachea.
Laryngoscopy has done much towards forming an
exact diagnosis, in laryngeal complications, with Tu-
berculosis, showing most conclusively, that other
morbid conditions (differing from Laryngeal Phthisis),
each distinctive in its symptoms and peculiarities,
may co-exist with Tuberculosis ; and in view of this,
it is proposed to devote this article to the considera-
tion of this morbid condition, and the differential
diagnosis between it and other affections of the lar-
ynx. While this disease is commonly secondary to
a tuberculous condition of the lungs more or less
extensive, it is not generally known that the affec-
tion of the larynx, primarily, is sometimes the only
indication of the commencement of Tuberculosis, so
marked and prominent in its nature, that the cough
and wasting appear to spring from it rather than
from the chest, to which point the attention had not
been directed ; and while nothing is more rare than
the existence of the disease under consideration, in-
dependent of Pulmonary Phthisis, it is equally true
that it may precede this condition. I cannot, there-
fore, but regard the usefulness of Laryngoscopy
demonstrated beyond cavil, when by its means an
exact diagnosis may be obtained of Laryngeal Phthi-
sis, even in its earliest stages, and before any tuber-
culous deposit can be found in the lungs, by a most
careful and thorough physical examination. The
importance of this fact cannot be overestimated, for
by means of the mirror, the physician is not only
warned of the approach of Tuberculosis by its fore-
runner, Laryngeal Phthisis, but the knowledge thus
gained may, through proper hygienic and precau-
tionary measures, prolong the life of his patient for
many years. The symptoms and laryngoscopic ap-
pearances of the three diseases of the larynx most
likely to be confounded with each other, viz. : I,
Laryngeal Phthisis ; 2, Chronic Laryngitis ; 3, Syph-
ilitic Laryngitis — will be described seriatim, with
the further remark in passing, that the title under
which the first named is spoken of is adopted in
preference to that of Tuberculous Laryngitis, inas-
much as the question, as to whether true tuberculous
deposits are ever found in the mucous membrane of
the larynx, is held negatively, by prominent laryn-
goscopists.
The parts most favorable to the invasion of this
malady are the ary-epiglottic folds, and the epiglot-
tis, although in the progression of the disease, the
ventricular bands and vocal chords are frequently
involved. The earliest subjective symptom is pain
in swallowing, and a laryngoscopic examination
reveals swelling of the cartilage of Wrisberg and of
Santorini, which, as the tumefaction increases, as-
sume a pyriform shape, and projecting on the carti-
lages, obscures the interior of the larynx. This in-
flammation is diffused, and its outlines fall into the
adjacent parts without showing any especial line of
demarcation.
The characteristic color of the parts just men-
tioned is pale and aenemic ; but when the vocal
chords are involved, they appear rough and thick-
ened, and of a dark red, or purplish color. There
is noticeable more or less hoarseness in the earlier
stages, terminating in Aphonia, as the vocal chords
and ventricular bands become involved. The parts
present a puffy, cedematous appearance ; the secre-
tion is thin, glary and tenacious ; and as the epiglot-
tis becomes affected, and assumes a thickened and
"turban-like" appearance, dysphagia is a marked
and distressing symptom. Cough, although some-
times wanting, is generally present, and is distinc-
tive and peculiar, having a stridulous, metallic
sound, which is quite characteristic of the conditions
just described. Another, and equally marked char-
acteristic, is the slowness of these tumefied parts to
ulcerate, and although the inflammation and swelling
may be very great, and the parts distorted almost be-
yond recognition, there is an indisposition to ulcera-
tion which is in marked contrast with another laryn-
geal affection yet to be mentioned. When, how-
ever, this process is established, the ulcerations are
small and superficial, partaking more of the charac-
ter of an erosion. The fauces present generally, a
pale, colorless appearance, accompanied at times
with such a degree of irritability and intolerance of
contact, with the mirror, as to render an examina-
tion a matter of considerable difficulty. Having
thus briefly described the symptoms and pathological
changes of Laryngeal Phthisis, it will be well to enu-
merate its distinctive points of diagnosis, before pro-
ceeding to the consideration of the other diseases
already mentioned. 1st, Pain in swallowing; 2d,
Location and character of the swellings ; 3d, Its
color and that of the surrounding tissues, and 4th,
Slowness to ulcerate. Chronic Laryngitis is not an
uncommon affection in our Northern sea-board
cities, and is more prevalent during cold, wintry
weather. The parts most subject to an attack are
the vocal chords and ventricular bands, then the
epiglottis, and lastly, and more rarely, the arytenoid
cartilages. This condition, depending as it does
upon more or less capillary engorgement, is dis-
tinctively hyperaemic in its nature, and the vocal
chords, ventricular bands, and surrounding mucous
tissue, are consequently bright red in color, varying
in intensity according to the activity of the disease.
There is usually but a slight degree of thickening
or tumefaction; the supervening ulcerations are
shallow, and when this process is extended to the
vocal chords, numerous bright, glistening points are
to be seen, caused by destruction of the lining mem-
brane, which exposes the fibrous structure beneath.
Aphonia, more or less marked, and fatigue in vocal-
ization are ordinarily present, but no pain usually in
swallowing, and seldom cough, but when it exists it
is irritative in character. There is rarely any em-
barrassment in respiration, and but little constitu-
tional disturbance. The pharynx is generally con-
gested, the uvula and soft parts relaxed, yet not-
withstanding this hyperaemic condition the parts
lack the exquisite sensitiveness of Laryngeal Phthisis,
and a view of them can in most cases be readily ob-
tained.
In Syphilitic Laryngitis, the epiglottis is most
IO
The Medical Union.
commonly the first affected ; following in frequency
of attack are the vocal chords and laryngeal cavity,
and more rarely the arytenoid cartilages. Ulcera-
tion, which is developed in the earliest stages of this
disease — unlike that process pertaining to the two
diseased conditions just considered — is rapid and de-
structive in its course ; the ulcerations, deep and ir-
regular in form, with edges raised and prominent,
are covered with a dirty yellow, or apthous secretion,
which reveals upon removal a hyperaemic base,
prone to bleed. The activity of this process causes
considerable surrounding tumefaction, which, how-
ever, is nearly always a sequel of ulceration, and
rarely precedes it. Cicatrization, which follows the
subsiding ulceration, affords distinctive characteris-
tics no less marked and important than those of the
ulcerative stage itself, consisting of radiating fibrous
bands so dense and contractile in their formation as
to frequently occasion both narrowing and displace-
ment of the larynx, and, according to Tobold, are
often "covered with abundant papillary growths."
This last observation, however, my experience has
failed to confirm. If, on the other hand, the ulcera-
tive process continues, the soft parts may be des-
troyed, Perichondritis induced, and the cartilaginous
framework of the larynx displaced. The symptoms
and appearances just enumerated obtain only in the
tertiary forms of Syphilis ; those conditions arising
from the Secondary type being mostly of an
erythematous nature, which either disappear spon-
taneously or yield quickly to treatment.
From a summary of the foregoing observations it
will be noticed that morbid changes as reflected in
the laryngeal mirror, afford positive means of diag-
nosis. In Laryngeal Phthisis, the ary-epiglottic folds
are most commonly the seat of attack ; and the
pyriform swelling of the cartilages, the peculiarly
tumefied epiglottis, as well as paleness of color, and
indisposition to ulceration are, each and all, char-
acteristic of this disease. It will also have been
observed, that while more or less swelling is usually
present in each of the diseases herein described, it
may be laid down as a rule, from which there is
rarely any deviation, that swelling in Laryngeal Ph-
thisis precedes ulceration. The cough — stridulous
and metallic — is also of value as a diagnostic symp-
tom, while pain in swallowing, which is usually pres-
ent, inasmuch as it accompanies in a greater or less
degree, all inflammatory conditions of the epiglottis
and inter-arytenoid folds, is not wholly reliable. In
Chronic Laryngitis there is little or no constitutional
disturbance; the interior of the larynx — the vocal
chords and ventricular bands — are markedly affected,
and, together with absence of cough and embarrass-
ment of respiration, form important and distinctive
differentiae. Syphilitic Laryngitis differs from either
of the preceding diseases, through the early develop-
ment of a destructive form of ulceration not pre-
ceded by any tumefaction, in connection with its
preference for the epiglottis, as its part of location.
The depth and irregularity of these ulcerations, the
rapidity of their course, together with the peculiarity
of cicatrization, may be regarded as typical.
ioo Lafayette Avenue, Brooklyn.
THE MEDICAL UNION CLINIC.
i . Fibro- Cystic Tumor of the Uterus, treated with
Muriate of Ammonia. In September, 1871, a
young lady was placed under my care with fibro-
cystic tumor of the uterus. The tumor was about
the size of a child's head at full term, and had been
growing for several years. During the last year it
had increased rapidly in size, and occasioned much
distress by its pressure on the pelvic organs. Flatu-
lence, constipation and inability to stand or walk for
any length of time were some of the concomitants
of the tumor. Being somewhat doubtful as to the
exact nature of the tumor, I had the patient exam-
ined by Drs. Marion Sims, T. G. Thomas, A. K.
Gardner, Washington L. Altee and others. Their
diagnosis was uniformly the same — fibro-cystic tumor
of the uterus. No encouragement was held out as
to any cure by medicines. I placed her on muriate
of ammonia, from three to six grains three times a
day, dissolved in a large quantity of water, and
kept her on that treatment for ten months. At the
end of that time the tumor was decreased to such
small dimensions that it could only be detected with
difficulty. The other troubles disappeared also, so
that, with the exception of a tendency to flatulent
distension of the intestines, she is now apparently
restored to perfect health. I have for a long time
used the muriate of ammonia in preference to the
iodide of potassium as an absorbent, and consider
it superior to any other remedy for that purpose.
I have never seen any bad symptoms arising from
its use other than an occasional dyspepsia that was
easily remedied by slightly diminishing the dose,
or omitting it altogether for a day or two. The use
of the muriate must be persisted in for months ;
there must be a slow saturation of the system with
the remedy in order to see its beneficial results.
I believe that the absorbent powers of muriate of
ammonia were illustrated in this case. The remedy
deserves a trial in similar cases, where absorption is
the only hope of cure, the nature or location of the
tumor forbidding operation.
John C. Minor, M. D.
Gold in Sea Water. — Sonstadt demonstrated
the presence of gold in sea water, held in solution
by the action of the iodate of calcium. He estimates
the proportion to be less than one grain per ton of
water.
2. Fibroid Tumor of the Bladder, treated with
Muriate of Ammonia. In June last, a gentleman,
well known in the literary community, applied to
me for relief from a trouble which he said was mak-
ing his life miserable. I found him weak, emaci-
ated, with a sallow face and a distressed look. His
age was about sixty. For years he had suffered
from a severe trouble in the bladder, which had
gradually been getting worse and worse. He was
hardly ever able to go more than a half hour with-
out an attempt to void water. The attempt was
often unsuccessful even after five or ten minutes'
trial, but on going back to his work the water would
not unfrequently commence flowing without warn-
ing, discharging itself into his pantaloons. Every
night he was obliged to get out of bed as often as
every half hour to void urine. A careful examina-
tion with the sound revealed a tumor in the lower
part of the bladder, somewhat in shape and nearly
the size of a small hen's egg. The cause of all his
trouble was apparent. An operation, at his age,
with his strength broken down with long suffering,
was only to be thought of as a last resort. I ordered
him to take ten grains of muriate of ammonia
three times a day. In a few days he informed me
The Medical Union.
II
the drug severely purged him and deranged the
stomach. I reduced the quantity to five grains to
be taken in a wine-glass of water. In a short time
marked improvement was apparent. He has re-
gained his usual strength and color, and says he
feels that he is a well man. He now passes water
but two or three times a day, and is not called up
at night. Under the action of the muriate of am-
monia the tumor has become entirely absorbed,
and every unpleasant symptom removed.
Egbert Guernsey, M. D.
3. Epileptiform Convulsions treated with Cedron.
Mrs. E., aged twenty-five years, native of England,
married, one child, always delicate. Four years
ago, for the first time had an epileptic fit caused by
fright. Since that time has had well marked epi-
leptic attacks on an average once every two weeks.
Dec. 3, P. M. — I was called to attend her. I
found her in bed, lying on left side, suffering from
violent pain extending from the spine around the
right side nearly to the mediaro line in front, and
from about the first dorsal to the last lumbar verte-
brae, attended with great sensitiveness to the touch ;
frontal headache, nausea and vomiting, thirst ; pulse
and temperature normal. This condition had ex-
isted for three days* during which time she has had
no sleep, nor been able to keep any food on the
stomach. No fit for two weeks. Prescribed.
Dec. 4, A. M. — Condition about the same as
yesterday. No sleep; temperature 100; pulse 80;
Ignatia Oj in water. P. M. — After taking two doses
of the remedy, pain in back and side relieved very
much, but is returning. Has "fainted" two or
three times ; otherwise about the same. Continued
remedy.
Dec. $, A. M. — No change in previous symptoms.
Has had seven or eight "fainting" fits since day-
break ; during my visit had two which I recognized
as Petit Mai. While lying quiet, without any per-
ceptible change in her appearance, she became
perfectly unconscious, respiration and heart's action
remaining natural. This condition lasted for three
minutes, when consciousness returned, with some
chilliness and thirst. The intervals between the
attacks varied from five minutes to two hours.
Prescribed Ars. 1st dry. Met Dr. Henry Paine in
consultation toward night, up to which time the
patient's condition remained the same. We decid-
ed to give Hyos. tinct. a trial, and should that fail,
then Cedron.
Dec. 6. — No change for the better. Gave Cedron
1st grs. xx, in a third of a glass of water, tea-spoon-
ful every hour till four doses had been taken, then
every two hours.
Dec. 7. — Patient had some sleep, the first in six
days ; was also able to retain some food on stomach ;
pain much relieved ; no more attacks of the Mai.
Gave Cedron 1st in powders of grs. v each, every
two hours.
Dec. 8. — Found patient sitting up, nearly free
from all pain ; had quite a good night's rest ; some
appetite, and no difficulty in retaining food. Im-
provement continued under this remedy in de-
creased doses, and patient discharged.
Francis E. Doughty, M. D.
itorrespcmbence.
A LETTER FROM JOHN CRANNELL.
My dear Union:
You want some of my studies for publication? Well,
you know that an artist's work is always a finished pro-
duction, while his studies are like mine — never done.
An artist's studio presents not only the finished work,
but also the chips and tools, the models and sketches
from which the complete creation has sprung. If the
work is on exhibition, the odd sketches and litter are
stowed away in some corner to escape the eye, which
appreciates only results accomplished, and has no time
or inclination for a study of the process of construction.
To the artist, however, these rough drafts — the dashes
of color, the odd pencilings and memoranda out of
which his work grew slowly and harmoniously — are of
peculiar value ; and while the critics are ushered in silence
to the presence of the completed work, he takes a friend
aside to look over those queer and curious scraps that
have lightened the burden of work and forced him to
laugh when it was decidedly his business to weep. In
like manner I find myself surrounded with a litter of
precious chips which I have no disposition to burn up.
Notes and pencilings on many quaint ideas and curious
customs lumber up my desk. They have accumulated
while I pursued some curious studies ; but now they are
in my way and I must either burn them or print them,
and so, my dear Union, you see me in print.
There is a peculiar fascination about the researches
into the history of old surgical operations which invests
them with a charm unusual to medical topics. We are
led back through the musty pages of medical history,
and in our studies we contemplate the relics of former
systems with a curiosity which is often repaid by the
recognition of old remedies and old instruments which,
under new names, are known in our day as evidences of
modern progress. As we pass along in our search we
see rival schools and systems of medicine lying dead and
buried side by side, with the mould of centuries quietly
enshrouding all alike, and we pause to think that we too,
with our wordy strife and all the rivalry between our
various schools, must at last find similar resting places
together, with every folly embalmed and every virtue
gone; for every sect and school will take its stand when
dead according to the measure of its weakest part when
living. If one school becomes contemptible on account
of intolerance and bigotry, and another school becomes
absurd from the ignorance and credulity of its members,
those facts will become eternal when all that was good
in either has been long forgotten. It is merely a ques-
tion of time which will make "our school," whatever
that school may be, a thing of the past, and in view of
this fact, he takes the safest course who uses his own
judgment in all professional matters, and exercises that
charity which refuses to recognize any school of medi-
cine as entirely right to the exclusion of any other as
entirely wrong. For what seems true to-day may be
proved false to-morrow, and the birth of a new idea is
sure to be the death of a dozen old ones. (The doctor of
divinity says that his opponent is "heterodox," and the
assertion is generally more profound than the proof.
The doctor of medicine overwhelms his rival by calling
him an "irregular," which signifies a medical heretic.
Now, Heterodoxy is another man's doxy — whereas Or-
thodoxy is a man's own doxy. This definition is an old
12
The Medical Union.
one, but it might be difficult to give a new one which
should be more accurate or more applicable to the case
in hand. )
We fall into these digressions as naturally as one wan-
ders off into the side alcoves of a museum, while the
first and final purpose of his visit draws him toward the
study of some antiquity at the remote end of the gal-
lery.
In tracing the history of an old operation, we some-
times find it associated and connected with the theories
of the times in which we regard it. The study of any
medical topic to-day requires a consideration of its rela
tion to the vital theory or the physical theory of disease,
because it is necessary to measure every practice pro-
posed by the line of every theory extant until something
fits ; since no matter what may be the success of the
practice, it requires a theory to cover and protect it, just
as a man requires a good suit of clothes before he can
be admitted into fashionable society. We must examine
our subject in the light of pathological knowledge, and
compare it with other measures used to accomplish simi-
lar results. In like manner we find that years ago
medical and surgical proceedings were associated with
the theories of the day, and were sometimes proposed
as one of the methods to perpetuate the period of youth.
Pathology was an unknown science then, and the vital
and physical theories of disease were unheard of. The
crucible of the alchemist, the tales of the traveler and
the records of tradition, were then the sources of knowl-
edge. Medicine was mingled with superstition, and
surgery was surrounded by a thousand horrors. Science
lay buried in a swamp of superstition, from which arose
a miasm which was apt to give men the shakes. It
may not be uninteresting, since our subject has led us
into these old times, to give a little attention to some
of the investigations which then occupied the minds of
the learned.
We are led back to the time of the old alchemists who
sought not only the power of transmuting baser metals
into gold, but toiled as well to discover the fountain of
youth, or to produce an elixir vitae which should obviate
the necessity of dying and render mortality immortal.
The measures proposed were generally of the most
absurd character, and when some foolish visionary dis-
covered what he supposed to be the secret of prolonging
life indefinitely, he was apt to die before he reached
three-score years and ten — a sufficient commentary on the
efficacy of his secret. With the details of these profit-
less labors we have little or nothing to do, but looking
beyond them we find that they occupied the attention of
curious and speculative minds in all ages, and we find
traces of this search for life scattered throughout the
literature of all countries, and where records fail us we
hear the story over again in the traditions of the people.
To some of these tales we now turn, not from mere
curiosity alone, but because it seems probable, from the
evidence of their construction, that the alchemists, in
seeking the elixir vitse and the fountain of youth, were
drawn on in their search by the mystic beauty of that
old story of Eden and the Tree of Life, and that, not
recognizing the antiquity and source of these old legends,
they blindly groped for that which is forever guarded by
the " cherubims and a flaming sword which turned every
way to keep the way of the tree of life." Herodotus
(Herodotus, Book III, Chap. 23) reports the existence
of a magic fountain in Ethiopia in the following words :
" When the Icthyopagi showed wonder at the number of
years, he [the king of Ethiopia] led them to a fountain,
where, when they had washed, they found their flesh all
glossy and sleek, as if they had bathed in oil — and a scent
came from the spring like that of violets." * * * " If their
account of this tradition be true, it would be their con-
stant use of the water from the fountain which makes
them so long lived." And here we have part of an old
twelfth century rhyme (Fabliaux of the Twelfth and
Thirteenth Centuries, selected by Legrand, translated by
Way. Ellis's Edition, Vol. II, p. 195) which locates the
fountain in the troubadour's paradise, "The wondrous
land that hight Cokaigne :"
* * " But the chiefest, choicest treasure
In that land of peerless pleasure
Was a well to saine the sooth,
Cleped the living well of youth.
There had numb and feeble age
Cross'd you in your pilgrimage ;
In those wondrous waters pure,
Laved awhile, you found a cure.
Lustihed and youth appears,
Numb'ring now but twenty years."
One of the most exquisite tales comes from Hawaii
(Robertson's History of America) in the shape of a
tradition concerning a voyage which certain natives of
that island made, to a land where the inhabitants enjoyed
perpetual youth and beauty — where the fountain of life
removed every disease and every deformity, and where
misery and death were unknown ; but, alas ! they had
beheld that which was forbidden to mortal eye, and they
all died shortly after their return to Hawaii. A similar
tradition prevailed among the natives of Porto Rico, who
located the fountain in one of the Lucayo islands, and,
incited by the hope of finding it, Ponce de Leon roved
from island to island till he discovered not the fountain,
but Florida. Sir John Mandeville, that quaint old
traveler of the fourteenth century, " who, on the day
of St. Michael, in the year of our Lord 1322, passed
the sea and went the way to Hierusalem and to be-
hold the mervayles of Inde," discovered, among other
"mervayles," a fountain on the banks of the Indus which
possessed healing and rejuvenating powers, and Sir John
not only describes the magical effects of its waters on
the inhabitants of the country, but gives us his personal
experience of its use. The old knight came back, after
more than thirty years absence "in strange countrie,"
afflicted with gout and rheumatism which the magic
fountain had failed to ward off, but as the Pope decreed
that all that Sir John Mandeville had related, "and much
more" was veracious, we, who are fallible, cannot dispute
the point.
Roger Bacon was a firm believer in the elixir vitse
and the philosopher's stone, and has left many curious
works (De Secretis Artis et Naturae; De Prolongatione
Vitse; De Secretis Operibus, etc., etc.) which show not
only a fertile imagination and childish credulity, but,
incongruous as it may seem, at the same time a brilliant
power of analysis which enabled him to detect the errors
of others while blind to his own.
But enough of these old stories for the present — the
ancient idea of perpetual youth has faded away, and its
place in science is now taken by researches as fascinating
as any of old. We will come to our modern times soon
enough, however, and there are some things yet to be
looked at before we leave our book-shelves, and so in
my next letter you will pardon the antiquarian proclivi-
ties of
John Crannell.
The Medical Union.
n
The Medical Union
A MONTHLY JOURNAL
Of Medicine, Surgery, and the Collateral Sciences.
Editors :
EGBERT GUERNSEY, M.D. CHARLES E. BLUMENTHAL, M.D.LL.D.
JOHN C. MINOR, M.D. ALBERT E. SUMNER, M,D.
Published on the First of each Month, by
C. T. HURLBURT, 898 Broadway, New York.
NEW YORK, JANUARY 1, 187S.
EDITORIAL NOTICE.
The editors of .the Medical Union invite the
co-operation of the profession in making their jour-
nal a valuable medium of scientific intelligence,
and a record of the freshest news in the medical
world. They trust the medical profession will look
upon the journal as, in a measure, their own, and
freely use its pages for the interchange of practical
thought. Every thoughtful mind can add some-
thing of suggestion and experience to the general
store of knowledge. We wish to bring together,
within our pages, the experience and investigations
of the great army of workers now laboring in the
broad field of medical progress. So far as this
journal is concerned, the editors occupy the posi-
tion of collectors of scientific intelligence and gen-
eral news more particularly relating to the medical
profession. They, of course, must exercise some
discretion in the discharge of their duties, and se-
lect for publication only that material which they
think will be of interest to the medical world.
While they aim to publish nothing which will re-
tard the progress of scientific medicine, they will
give a broad range to scientific discussion — always
conducted in a spirit of courtesy — holding that
each man must be alone responsible for the senti-
ments he advances. Secretaries of medical socie-
ties are earnestly requested to forward a rec-
ord of the proceedings of their societies. Very
much is brought out in the off-hand discussions of
these associations by men who are too busy to write
long articles, which will be of great practical value.
Records of cases and little incidents in the daily
round of professional work may thus be brought
together from every part of our vast country, form-
ing an immense treasury of knowledge. We trust
these reports will be made as full as possible. Our
reviews of new books will be in the interest of no
publisher, but of the general reader. We shall
strive to deal fairly and impartially with all. In
this way only can reviews be of any real value.
Again, we ask our brethren in the profession to
look upon this journal as in a great measure their
own, and by their contributions make it second to
none in the medical world. The publisher desires
us to say that its publication for one year is assured
by the pledge of sufficient funds to cover its entire
expense for that time, even if not a single copy is
sold.
SALUTATORY.
The great object of the physican is, not only to
cure, but to guard against the inroads of disease.
His chief study should be, how to relieve suffering,
prolong life, eradicate the causes of disease, and
thereby elevate the human race, and increase the
sum of human happiness.
To do this, he should ever stand in the vanguard
of progress. His mind, carefully trained, thoroughly
disciplined, should be able to discriminate between
crude speculations, however beautiful the theories,
and the logic of facts. The broad field of science,
with its wonderful developments and the startling
truths every day revealed, should find in him a pa-
tient worker and an honest, earnest searcher after
its mysteries. The questions which should ever
ring in his ears should be, " What is truth ? How
can I best bring the teachings of nature to subserve
the interests of humanity ?" Honest in his own con-
victions, earnest in his purposes, fearless in his
investigations, he respects the intelligent opinions
of others, though they may differ from his own. He
subjects their ideas and their facts to the careful
analysis of his own mind, that, if he may not wholly
approve and indorse, he may, at least, gather from
their investigations some grains of truth — some new
thought — which may aid him in his own daily com-
bat with disease. In every thus earnest worker
he recognizes a friend and brother, a co-worker
in the same great field, actuated by the same pur-
pose, striving for the same end.
In coming before the public with a new journal,
for its approval, we come not wedded to old ideas,
not bound hand and foot to any philosophy, but
culling facts from the experience of the past, from
the investigations of earnest minds in all ages, we
appropriate them to our use, and not only continue
our investigations in the rich veins they have
opened, but patiently watching day by day the
developments of science, listening to its teachings,
earnestly search for some new fact, some new mine
of wealth from which we can draw more potent
weapons to cleanse the current of life, and combat
with the causes of disease and death.
In the way which seems to us most likely to
be rich in practical results, we shall pursue our in-
vestigations ; and if at any time we can be shown a
better way, a more reasonable philosophy, more in
accordance with the teachings of science, we shall
willingly and gladly walk therein. Extending the
hand of fellowship to all honest, intelligent workers
14
The Medical Union.
in the great field of scientific research, we shall
work earnestly for that time when the party walls,
which never would have been reared except from
persecution, shall be leveled, and all sectarian
names merged in the broader name of Physician.
Intolerance, bigotry and persecution commenced,
and have kept alive the feeling of sect. Standing
in the ranks of the so-called Homoeopathic school,
we say to that part of the profession who claim to
be the only regular school of medicine, if we are a
sect you have made us one. We have been obliged
to assume a distinct name and build a home for
ourselves, because we have been driven from your
ranks by the bitterest persecution and the most un-
sparing abuse.
We deny that there is anything schismatic in our
doctrines, our spirit, or our manner of practice.
The principles upon which are based the doctrines
of the Homoeopathic school were promulgated with-
in the ranks of the dominant school by one of their
own most accomplished and learned physicians.
His very position as a man of science should have
entitled his views to a fair hearing and an impar-
tial investigation. Had this been done, the Homoeo-
pathic school, as a distinct school, would never have
existed. If we claimed not merely a therapeutics,
but a physiology and pathology of our own, and
were responsible for every theory and every infer-
ence drawn from the law of Similia either by Hahn-
emann, or any of those who have accepted that law,
and taught that disease could only be successfully
treated by the extreme high potencies, the case
would be entirely different. But these extreme
views have ever been the exception rather than the
rule in our school. Homoeopathy is no more respon-
sible for them than for anything else which may be
placed upon its shoulders. They are the views and
practices of individual men, for which they alone
should be responsible. What we as homoeopaths
claim as cardinal principles, are, first, the law of
Similia, or the treatment of disease by medicines
whose effects, tested upon the living, healthy or-
ganism, are similar to the symptoms present in
diseases. We do not claim this principle as uni-
versal and exclusive. We claim that it is a principle
of great value, and one which, carefully considered
and correctly applied, gives us, when indicated, the
most satisfactory results. We ask, in all fairness,
that in no case should prejudice act against its fair
consideration.
We claim, secondly, that as the law of Similia
demands an intimate knowledge of the effects of
the drug, the importance of proving each drug on
the healthy organism. In this way can its real ac-
tion be ascertained, and we no longer be compelled
to depend on the chance-provings given in acci-
dental cases of poisoning.
If our Symptomen Codex contains much that is
unreliable, give us something better, but at least
confess we are on the right track, and that in this
way lies the true channel of investigation.
We are quite willing that the subject of dose be
left to the individual experience and judgment of
the practitioner. We find that a greatly reduced
dose gives us the most satisfactory results, when
the remedy is given in direct accordance with the
law of " Similia." What the precise dose shall
be, must depend on the condition of the patient
and the idiosyncrasies of his constitution.
We do not claim these principles as exclusive,
notwithstanding we believe they have simplified the
treatment of disease, and opened to us a vast field
of remedial agents, the limits of which we have as
yet by no means reached. They have unlocked the
hidden virtues of plants and minerals scattered
about us in rich profusion, and have taught us there
is no disease for which we may not hope to find,
in the rich store-house of nature, some antidote.
Whenever we think them needed, we use drugs
which do not act in accordance with the principle of
Similia, and in such doses as we think will produce
the desired results. We admit that, notwithstand-
ing the discoveries and experience of each year are
adding to the strength and scope of this principle,
still it is not universal. Remedies are often re-
quired for their chemical action, often as nutrients,
supplying some deficiency in the organism, and
often for their mechanical action. All that we ask
of the physician is a careful discrimination of how,
and in accordance with what principle, the remedy
should be given. We ask for the homoeopathic
law, that it be recognized and its proper value al-
lowed.
Is there anything schismatic in the position we have
assumed, anything to justify the bitterness with
which we have been assailed, anything to warrant
the treatment we have received from a school which
prides itself upon its antiquity, its learning and
skill ? The argument will not hold good that our
physicians, as a class, are ignorant, without cul-
ture, without scientific attainments, and with no
social position — for in all these they are fully their
equals. Our patrons, too, are found among the
cultivated and refined — among people who reason,
and who, when suffering, seek for help where they
think it can best be found.
Gentlemen of the so-called school, Allopathic, or
as you prefer calling yourselves, " the regular school
of medicine," if you wish for reconciliation we are
quite willing to meet you half way. We admit that /
in the past there have been sharp words on both
sides. To your sneers and your ridicule we have
replied by an array of facts, and challenged you to
disprove them. We have let the sunlight of truth
The Medical Union.
15
into much that was unscientific in your practice.
We have at all times been willing and eager to
investigate carefully whatever we have found in
medical literature, derived either from experience
or scientific reasoning, and have honestly appro-
priated what we considered truth, from whatever
school it may have emanated. We have at all times
been willing to communicate our ideas to others,
either in the sick-room or in our medical journals ;
and while we have always been ready to treat others
with the respect and courtesy which should ever
exist between members of a learned profession, we
have not received the same courtesy from you.
You have tried to crush us out of existence by your
bitter opposition; your refusal to recognize us as
physicians ; your closing the doors of hospital and
asylum boards against us ; your determination that
we shall occupy no places on the army and navy
surgical and medical staff, and the prompt expul-
sion, or suspension of all members of your societies
who have the independence to meet us in council.
In fact, gentlemen, you have shown a fixed deter-
mination to throw every obstacle in your power in
the way of a fair representation of our views and
practice.
Has the result been entirely satisfactory ? Have
you read the world's history so poorly as not to
know that persecution such as you have shown has
never succeeded in accomplishing its purpose ? that
it always aids the cause it seeks to destroy ? In all
this, the public are rapidly answering the question
which they deem the more schismatic, and whose
code of ethics to their unprejudiced eyes seems most
in accordance with gentlemanly courtesy, and that
broad charity which should ever be found in the
heart of the man of science and the true physician.
Look abroad upon the medical world with a fair
and impartial eye, and compare the present with
twenty years ago. No longer weak in numbers and
influence, our colleges, our asylums, our hospitals,
our dispensaries are scattered all over the land, and
statistics which cannot be disproved, tell largely in
our favor. Deprived of all fair representation in
your medical journals, shut out persistently from
hospitals, asylums and dispensaries established for
the public good, and supported by our money as well
as yours, we have been compelled to establish them
of our own. We have called our literature and in-
stitutions "Homoeopathic," not because we claim an
exclusive devotion to that creed, not because we
believe the law of Similia covers the whole range
of the remedial action of drugs, but because here the
Jj Homoeopathic creed is recognized and allowed its
proper value.
Because you have compelled us to adopt this
course, you now taunt us with being sectarian and
adherents of an exclusive dogma.
What would be the result, gentlemen, of a little
common fairness in this matter — of a little of that
frank and sensible treatment which we ought to ex-
pect from the members of a great profession, work-
ing for the relief of suffering humanity? Compare
your own teachings and practice now, with those of
a quarter of a century ago, and tell us why the line
of demarcation between the more conservative of
the two schools is daily becoming less apparent.
Why is it that your ablest writers on Materia Medica
admit that the best way to get at the action of drugs,
and the surest guide to their curative properties, is
by proving them on the healthy organism ? Why
is it every day you are treating your patients more
and more in accordance with the law of Similia?
Is it not because the influence of the Homoeopathic
school has been quietly producing its beneficial re-
sults upon the whole medical world, and even you
are convinced there is a better way than that of the
past?
We have none of us as yet, by any means,
reached the limit of human knowledge, so far as
remedial agents are concerned. We have all much
to learn. We are convinced there are many things
you can learn from us, and there is much we can
learn from you. We are all striving for the same
great end. Is your armory so well supplied with wea-
pons to combat with disease that you have no oc-
casion for others ? If statistics show the percentage
of deaths to be less in our hospitals and dispensaries
than in yours, is it not reasonable to suppose that
we may have some weapons which would prove
beneficial to you, and that you might with advan-
tage make our creed part of your own ? We do not
hold our creed responsible for many of the inanities
which have been put forth in its name, any more
than we hold your own profession responsible for
some of the vagaries of its members.
Supposing you should throw open the pages of
your medical journals to a fair and honest considera-
tion of the doctrines which form our creed; suppos-
ing you should give up this exclusive sectarian spirit,
and throw open the gates of your hospitals, and asy-
lums, and dispensaries to educated Homoeopathic
physicians, allowing them the same privileges in
the wards as yourselves ; and supposing, too, in the
lecture rooms of your colleges a fair and just expo-
sition of our doctrines should be given, what would
be the result?
The name " Homoeopathic " would disappear
from our literature, from our colleges, our dispen-
saries and our hospitals, as you claim that of Allo-
pathic is not recognized in yours. Standing high
above all sectarian names, would be the glorious
title of Physician. With united strength we could
work in harmony and with a power never exerted
before.
\6
The Medical Union.
You have it in your power to terminate this war-
fare of bigotry and intolerance, unworthy of an en-
lightened age and of the true spirit of science. You
have only to step out from your shell upon the broad
catholic platform of equal rights and equal justice
to all. Until you are willing to take this course,
this contest will go on until we obtain our just
rights in the army, the navy, and in all the hospi-
tals and asylums built by the public money (by our
money as well as yours), for the public good. In
the cities of New York and Brooklyn, at least one-
half the taxes are paid by those who use homoeo-
pathic treatment themselves and in their families,
and yet their physicians are persistently excluded
from the hospitals and have no voice in the man-
agement of the sick poor within their walls.
While we are willing and ready at all times to
meet scientifically educated physicians and work
with them earnestly for the public good, no matter
to what school they may belong, or whether they
are male or female, white or black, we wish it dis-
tinctly understood we have no apologies to offer for
the past, no favors to ask for the future. We
simply demand our rights, and insist that the sec-
tarian dogmatic spirit which has so long sought to
dictate medical ethics to the medical world, and
which has built up party walls and engendered all
the bitterness of party feeling shall cease. That
spirit is already being shorn of its power — its an-
athemas cease to terrify and its thunderbolts fall
harmless at the feet. Earnest, truthful men are
everywhere rising above the dictates of party, and
in the catholic spirit of true science, are working
heartily for the common good The time is not far
distant when all true men in our noble profession
will indignantly spurn the trammels of sect with its
petty spites and narrow-minded prejudices, and the
only contest will be, who shall do the most to pre-
vent disease and relieve suffering humanity. For
that time we shall earnestly work.
Reuieuis of Boohs.
Lectures, Clinical and Didactic, on the
Diseases of Women. By R. Ludlam, M. D.
Chicago : C. S. Halsey. Second Edition.
The appearance of this volume prepossesses us in its
favor. It is mechanically a very neat work, and
highly creditable to the typographical art of Chica-
go. This, however, perhaps is partially owing to
the fact that so much old type and poor book mate-
rial was destroyed by the recent conflagration.
As to the work itself, we confess to have read it
with no little interest. It is fresh, readable, agree-
able in style, easy, and fluent, while, at the same
time, it is not a little rambling, discursive, and incom-
plete. Of this we could not complain, if it were not
that it will be apt to be considered a complete treatise
on female complaints, which it is very far from be-
ing. It is, as it calls itself, a series of lectures — clin-
ical lectures, indeed — unstudied, except in some af-
ter filling up, desultory, irregular, heterogeneous,
and incomplete. Scarcely a single disease, or feature,
or treatment of any complaint is exhausted, although
touched upon in many places. As an index of the
mind and character of the writer himself, the pages
throughout are all sufficient. It evinces him to be
a well-read, thinking, practical man, one not bound
down by the theories of days of intellectual dark-
ness, but fully imbued with the light of the present
day and age. The practitioner of medicine will
gladly meet the writer and learn from his evident
abundant knowledge of this subject, both at the bed-
side of the patient and in reading these pages. But
for the learner, the work is not the one for his careful
study. The writer has made a place for himself on
the book-shelf by the side of Meigs and Thomas, but
the student needs more didactic instruction as con-
veyed in the sententious and carefully weighed words
of Gooch, Dewees, Churchill, Byford, and, more
than all of the incomparable and exhaustive treatise
of Scanzoni, a writer, by the by, that we see too
rarely alluded to by the erudite writer now before us.
We are glad to note as signs of the progressive
writer, that he unites in the reprobation which the
leading gynecologists of the world now give to the
abomination of all abominations, the pessary in
every form. Their constant use by any physician
evinces him as a man of little observation of the
causes of disease and less appreciation of a proper
method of cure.
The writer, too, "is sound" upon the question of
uterine therapeutics, and justly says that the more
showy operations of the modern specialists have
driven out to a very great degree that internal — we
might say constitutional — medication which has a
very great, if generally neglected or forgotten, in-
fluence over such complaints. Did uterine diseases
all commence from mechanical causes, then local
and topical applications might suffice for their re-
lief ; but it is true that many, if not most, of them
originate from constitutional disturbances, aggra-
vated indeed by excessive coition, abortions, and like
local irritants unnecessary to enlarge upon here ; and
in such cases, the axe laid at the root will be the ap-
propriate internal remedy for a general cachexia, a
constitutional disturbance, or frequently if most
often unrecognized, and imperfectly understood, ner-
vous sympathy, an influence subtle, unseen, but
which will be more generally appreciated when by
superior education and enlarged study the nervous
system and its part in the human economy is better
understood.
Scanzoni pointed out, and perhaps proved, that
cancer in some cases originated in sorrow, mental
disquietude and suffering. It, not unlikely, requires
but time for the mental and moral causes of many
physical diseases to be discovered and recognized.
Another step in this direction is the recognizing
that hysteria and uterine irritation are coincident;
perhaps the future may show that the uterine diffi-
culty may be either primary or secondary.
In addition to what the author has said, had he
lived in New York he might have added that some of /
the most noted of these specialists have forgotten ^
something of the Hippocratic oath, and taken in its
place maxims from the Tweed and the political
"rings" of the day. They perform useless and
even injurious operations simply for the exorbitant
The Medical Union.
17
fees they charge. It is easy to "slit open an os,"
h and then it is easier to charge $500 or $1,000 from a
confiding and credulous wife or her affectionate hus-
band. Imaginary polypi and tumors are treated,
and simple complaints are baptized with new Ger-
man names, and extraordinary and equally as un-
called-for sums are extracted from the credulous.
Quackery of the most unblushing character is now
not practiced by the ignorant seventh son of a sev-
enth son, but is in the academies of medicine and
the halls of science all over the land.
In the therapeutics we would be better pleased
were the author more explicit in his indications on the
quantity and strength of his preparations and the
frequency of their administration. For example,
upon page 195, under the head of "Treatment for
the Ovarian Symptoms," is "Apis mellifica, cal-
carea carbonica, platina, belladonna, colocynth,
lachesis, thuja, kali jodatum, mercurius or hama-
melis may be appropriately and successfully em-
ployed." Some of these are quite powerful, and it
might be very important how and when they should
be employed, more especially when there is nothing
in the work to indicate whether the writer is "of the
most straitest sect a Pharisee," or whether his motto
is "that liberality I to others show, that liberality
show to me." Sold by C. T. Hurlburt. Price,
$7.5o.
Marvels of Nature, Science and Art. i.
The Moon. II. Electricity, ill. Water. Scrib-
NER, Armstrong & Co., Publishers, New York.
On our book table we find the three works indicated
above, forming a part of the admirable series of sci-
entific works now going through the press, and re-
cently published by Scribner, Armstrong & Co., un-
der the general head of "Marvels of Nature, Sci-
ence and Art"
The advances of science during the past few years
have been so great, the revelations in the world of
nature so startling, that the mind can scarcely keep
pace with the new ideas and new truths which are
being developed in such rapid succession. There is
a vast number in this working world who have no
time to follow the minute details, often painfully la-
borious, by which the grand problems of science are
worked out, and yet who are eager to learn the re-
sult, and who feel their souls expanded and their
minds strengthened for their daily toil as they con-
template the great truths and the beautiful les-
sons of nature, unlocked from its store house by the
patient investigation and laborious research of others.
It is for this class of minds this series of works are
intended. They contain the results of the latest re-
searches in the world of science and art, told in lan-
guage easily understood, and will prove of vast inter-
est to those who have no time to follow the laborious
steps of investigation.
1. The Moon : with illustrations of its vast moun-
tains and deep valleys, and its various phases and
changes, by Amedee Guillemin, edited by Maria
Mitchell, of Vassar College. The editor says in her
preface, " This work is adapted to that large class of
^ persons, who, in an age which tends very decidedly
to physical research, wish to know something of sci-
entific facts j those whose occupations do not afford
them time for study, or who from defects in their
early training believe themselves incapable of math-
ematics. From the first page to the last there is not
a problem ; not a triangle is drawn. Although as-
tronomy and the laws cif motion cannot be studied
without the highest mathematics, the facts which ob-
servation and theory combine to make known can
be gathered together and made attractive to the gen-
eral reader, so that the narrow boundaries of ordi-
nary daily life may be extended by a conception of
the expansion of space and the cycles of time. "
11. Electricity, by T Baile : edited by Dr. John
W. Armstrong, President of the New York State
Normal School, gives a very clear description of the
electric telegraph, inductive machine, electric light
and its uses, and electro-plating.
- ill. Water, by Gaston Tissandier : edited by
Schill de Vere, D. D., LL. D., with sixty-four illus-
trations. We are told, in exceedingly graphic lan-
guage, of the wonders of the ocean ; the system of
circulation of water in its solid, liquid, and gaseous
forms ; its action upon continents ; its physical and
chemical properties and uses. Much of valuable in-
formation is found here even for the scientific reader,
and for the general reader the work is full of instruc-
tion and interest.
The International Scientific Series. D.
Appleton & Co., Publishers, New York.
From the author's preface we copy the plan of the
intended series. "The rapid development of sci-
ence in the present age, and the increasing public
interest in its results, make it desirable that the
most efficient measures should be adopted to elevate
the character of its popular literature. The ten-
dency of careless book-makers to cast their crude
productions upon the public has hitherto been so
strong as to bring discredit upon the idea of popular
science. It is intended to counteract this tendency
by publishing a series of popular scientific books,
prepared by the leading thinkers of different coun-
tries, and known as the International Scientific
Series."
The publishers have been fortunate in securing
the services of the great English scientist, Prof.
Tyndal, to prepare the initial volume of the series.
He has chosen for his subject " The Forms of
Water in Clouds and Rivers, Ice and Glaciers,''''
and it is handled with his usual clearness and skill.
There is a great charm in Tyndal's style, and the
reader is carried along by the great master mind by
easy stages, until, almost before he is aware of it, he
is master of the subject. His description of the
wave theory of light is exceedingly beautiful, and
his illustrations, in which he sifts the sunbeam so as
to intercept the light waves and allow the dark, or
heat waves, to pass unimpeded, and vice versa, are
very simple and telling. He shows that the heat
waves may exist in a perfectly dark room sufficient
to fuse metal, while the light waves contain no heat,
and thus shows that it is not only the sun's fire
which produces evaporation, but a particular con-
stituent of that fire, the dark waves. It is these
lightless waves which, falling on the glaciers, melt
the ice, the light waves not having power to
melt the most delicate hoar-frost. And so the
reader is led along, step by step, from one point of
interest to another, each point amply illustrated.
He sees the causes of oceanic distillation, of tropical
rains, and how the mountains act as condensers, and
the formation of the beautiful crystals of ice and
snow, showing how each particle of water floating
i8
The Medical Union.
in the atmosphere has its attractive and repellant
poles, such as we see in the magnet. The beautiful
crystaline forms and the fairy architecture which we
see in the snow and ice are explained.
Want of space forbids our following out the writer's
train of thought. The work is a thoroughly scien-
tific treatise, without the dry detail of the text-book,
and gives the reader, in language and illustrations
easily understood, the result of the latest investiga-
tions upon the subject of which it treats.
The works of Prof. Tyndal will possess an addi-
tional charm to the thousands who will have the plea-
sure of listening to his lectures during his present visit
to this country. It speaks well for the growing taste
of our community for scientific culture when we see
the eighteen hundred seats of the Hall in Cooper In-
stitute filled night after night by a thoroughly appre-
ciative audience to listen to lectures upon science.
Among the audience are seen not alone the profes-
sional scientific investigator, but merchants, and
lawyers, and doctors, and divines, and artisans. Men
of all grades and all positions, from the judge to the
simple mechanic, meeting here on common ground,
drinking in the same great lessons of truth, and
learning more and more of the beautiful harmony
of the divine mind as displayed in all his works.
Science, after all, is the great democracy, the leveler
of all distinctions. The more we study the laws of
nature, the more our minds become attuned to the
great law of beauty and harmony, which runs, like a
beam of light from the divine mind, through all his
works.
California; for Health, Pleasure, and
Residence. By Charles Nordhoff. New
York: Harper & Brothers, Publishers.
Mr. Nordhoff has been so long and favorably
known to the reading public, in connection with the
great publishing house of Harper & Brothers, as
the managing editor of the Evening Post, as a bril-
liant essayist and charming writer of books, that
any work coming from his pen will be read with
more than ordinary interest. It is no longer essential
in good society that a person should have made a
trip to Europe, have tramped over the Alps, and
have floated in the gondolas of Venice, along her
canals, and visited every picture gallery and ruin in
Rome. The tide of pleasure travel along our eastern
sea-board is rapidly turning westward, and we are
learning that our own country possesses grander
scenery, more beautiful landscapes, and brighter
skies than anything of which Europe can boast.
Mr. Nordhoff's book, to the traveler seeking after
pleasure or health, is- packed full of just such infor-
mation as he needs, told in the most graphic and
charming manner. We are taken leisurely over the
mountains and along the plains, stopping at points
of interest, and making detours into the mountains
to visit lakes, and springs, and natural curiosities,
such as can be seen in such grandeur and beauty no-
where else in the world.
The greatness of California, its beauty, and wealth,
and grandeur, its fertility of soil, its immense agri-
cultural and mineral resources, its wonderful fruits,
and delicious wines, all seem to appear before us as
if produced by the wand of an enchanter. As he de-
scribes the bright skies and the air full of life and
strength, of some favored spot, we involuntarily ask
why should our invalids, the worn-out men of busi-
ness, the consumptive, the dyspeptic, seek a foreign
clime when one so much more genial can be found
in our own land ?
The physician will find one of the most interesting
chapters in the book, that devoted to climate. He
often hesitates in recommending his patients to go
abroad, when in doing so he knows he is putting a
stormy ocean of three thousand miles between them
and their homes. Now, a few days' ride, in a com-
fortable car, furnished with almost every luxury and
comfort to be desired in traveling, takes one away
from our chill winds into a bright and genial clime.
He says: "Southern California presents a most
gloriously invigorating, tonic and stimulating climate,
very much superior to anything I know of, the air is
so pure and so much drier than at Mentona or else-
where ; and although it has those properties, it has
the most soothing influence on the mucous mem-
brane, even more than the climate of Florida, and
without its enervating effect. It is quite as stimu-
lating as Minnesota, without its intense cold.
"All the leading physicians in the world agree that
a tonic, stimulating, dry climate is the best for the
great majority of cases suffering from pulmonary
disease, or from a lowered vitality. The patient
needs a climate in which he can spend most of the
day out of doors. In Mentona and in the towns of
the Rivere, the doctors always advise the patients to
be in the house one hour before sundown, the
changes are so great, and not to go beyond pre-
scribed limits, because the winds are so cold and
the draughts severe. In California I have con-
stantly been out evenings. During the past winter,
out of one hundred and fourteen days, I have spent
one hundred and six in the open air. This was part
of November, December, January, and February.
"Italy is generally a poor climate for invalids, and
the pure blue Italian skies are not to be compared
to ours; at least, with anything west of the Missis-
sippi. One can come to California and spend the
winter as cheaply as at Vevay, Clarens or Mon-
treux — and those places are the cheapest winter re-
sorts in Europe. For instance, at Santa Barbara
or at Hortons, in San Diego, one can board by the
winter at $48 a month."
We append a short extract from meteorological
tables given at the end of the book. At San Ber-
nardino, during the month of January, there was but
one rainy day, and but one day when the wind was
very strong. The average temperature was $8°.
In February there were two rainy days, and no day
when the wind was very strong. The average tem-
perature was 62°. In March there were no rainy-
days and no strong wind. The average tempera-
ture was 640.
In Santa Barbara the average of the daily ob-
servations were: In December, 52. 120; January,
54.5 1°; February, 53.35°; March, 58. 420. The
air is clear and dry.
In conclusion, we have only to add, the work is
beautifully illustrated, some of the engravings being
gems of art.
General and Differential Diagnosis of
Ovarian Tumors, &c. By Washington L.
Atlee, M. D. 8vo, pp. 482. Philadelphia :
J. B. Lippincott & Co. 1873. • (
THIS work of Dr. Atlee's is unquestionably one of
the ablest that has ever been issued from the med-
ical press of this country. It possesses not only the
merit of ability, but is remarkable also for original-
The Medical Union.
19
ity and for the most perfect candor. Dr. Atlee
seems to take us at once into his confidence, and
in the most genial and unassuming manner goes
with us over the subject in hand, explaining the
steps he took in attaining a position, second to
none, as an accurate diagnostician. " The reader,
in perusing this volume," says our author in his
preface, " will notice that, while the text carefully
indicates the particular points of diagnosis, the
illustrative cases frequently reveal errors committed
by the author. He has purposely drawn from his
early experience, at a time when he was most liable
to err, in order to illustrate, step by step, the pro-
gressive advancement of knowledge in the diag-
nosis of abdominal tumors, and to show that the
observer in this, as in other forms of disease, must
necessarily be educated by repeated observations
before he can be qualified as an expert. He has
written only for those who have not traveled over
so large a field as himself, and who, warned by his
mistakes, may thus be guarded against the quick-
sands which he encountered in his earlier professional
career. Mistakes teach most valuable lessons, and
when discovered are not likely to be repeated.
Hence, in medicine, they should be recorded for
the benefit both of science and humanity. It is on
this account that the author has not shielded him-
self from his own criticism and has been free in the
acknowledgment of his own faults in diagnosis.
Having commenced the study of this subject at a
period when not only the literature of the profession
was greatly deficient, but when the whole medical
world denounced and opposed ovariotomy, he had
little else than the book of nature before him and
the consciousness of right to sustain him. He
greatly needed just such written clinical instruction
as is herein presented to the profession. Had his
pathway been illuminated by a similar beacon, he
is satisfied that humanity would have been the
gainer, and that his own record would have been
better." Having thus indicated the method he
proposes to adopt, the author plunges at once in
medias res. There is a natural surprise on the
part of the reader, because he is led directly at the
subject in hand without any preliminary discussion
about the pathology of ovarian tumors. The
reader will also be agreeably disappointed in miss-
ing the customary repetition of the time-worn ex-
periences and opinions of others. Dr. Atlee de-
pends on his own ripe experience and draws from
his own ample resources. He starts out with the
expressed intention of teaching the general and
differential diagnosis of ovarian tumors ; he keeps
steadily, thoroughly, and exhaustively to his subject,
and when the end of the volume is reached we feel
that there is nothing more to be said. We select,
almost at random, some passages illustrating the
author's views on various points and giving an idea
of his style :
u Tapping. — One of the most important means of
diagnosis in ovarian tumors is tapping. It gen-
erally affords us undoubted information of the pres-
ence or absence of ovarian disease, aids us in detect-
ing adhesions, and in deciding upon the true char-
acter of the tumor. As a means of diagnosis, how-
ever, tapping should not be performed in the early
period of the disease, unless it be done in reference
to the propriety of ovariotomy, yet it would not be
improper to tap at any period with a view of relieving
urgent symptoms not amenable to ordinary med-
ication. On the other hand, ovariotomy ought
never to be attempted by the inexperienced sur-
geon, should he not be able to avail himself of
enlightened counsel, without previously resorting to
tapping as a means of diagnosis. Several cases of
ovariotomy have been attempted where no tumor was
found. Had these proceedings been premised by
tapping, these patients might have been saved a
hazardous operation, their surgeons extreme morti-
fication, and the charge of ' difficulty of diagnosis '
— as an argument against ovariotomy — to this ex-
tent at least, could not have been maintained.
The only two operations in this city where ' no
tumor ■ was found were performed by two very
respectable surgeons, — one of them quite dis-
tinguished,— and in neither case, as I have been
informed, did they avail themselves, in their very
limited experience in the treatment of ovarian dis-
eases, of this indispensable means of diagnosis."
The value of tapping as a means of diagnosis be-
comes more apparent when we consider the use of
the microscope in revealing the nature of the fluid.
Dr. Atlee gives special prominence to the fact that
a free, delicate granular cell is characteristic of
ovarian fluid, and in no disease can the microscope
be of more assistance than when used according to
our author's directions for the diagnosis of ovarian
tumors. Four cases of cysts of the broad ligament
are given in detailing the diagnostic steps to be
taken in that disease, and then our author con-
tinues :
" Now, after having detailed these four interest-
ing cases, let me recur to the question, How can
we distinguish an ovarian cyst from this form of
cystic dropsy ? The answer is, By the character of
the fluid.
" In recording the first case I made this memoran-
dum : I took from the patient a large bucketful
of beautifully clear, transparent fluid, which did
not coagulate either by heat or nitric acid. The
fluid was so clear and transparent that ^the fibrous
structure of the boards forming the bottom of the
bucket could be readily seen and appeared to be mag-
nified.
" In the second case the record is : Eighteen pints
of clear, transparent, crystal-like fluid, very thin,
free from any tinge in bulk. It gave no reaction
with litmus-paper, and did not coagulate by heat.
Placed in a wineglass and examined by trans-
mitted light, it exhibited a slight opalescent tinge.
"In the third case: Thirty-five pints of trans-
parent fluid, as clear as spring-water. The fibres
of the wooden bottom of the tub could be distinctly
seen through it. It did not coagulate by heat, but
when boiled, exhaled an osmazome or soup odor.
"And in the fourth case: Fifty-one pints of se-
rous, transparent fluid having, in the sun's rays,
a slightly bluish tint and quite free from albu-
men. * * *
"Here I will digress a moment to observe that
up to this period of my experience I had supposed
that medication, after tapping, was necessary in or-
der to complete the cure of this form of dropsy.
Further observation, however, has satisfied me that
tapping alone will sometimes be followed by a dis-
appearance of the disease, particularly when the
operation is performed by a large trocar. If the
opening through the thin cyst remains patulous, so
that the fluid, as fast as it is generated, can escape
into the cavity of the peritoneum, the accumulation
20
The Medical Union.
will not recur. The fluid, in these cases, unlike
ovarian fluid, is absorbable by the free surface of
the peritoneum, and if the absorbents are sufficient-
ly active it will be readily taken up. Sometimes
the opening in the cyst closes up and the accumu-
lation of "fluid recurs: Hence, to meet these
contingencies, I have originated the operation, to
be hereafter referred to, of making a small opening
in the linea alba, tapping the cyst, and afterwards
drawing out and excising a portion of it, and re-
turning the remainder, so that closure of the open-
ing cannot thereafter possibly take place."
As illustrating the importance of tapping for
diagnostic purposes in doubtful cases we give an
abstract of one of Dr. Atlee's cases (case xxvin)
with the author's remarks. This case was consid-
ered as one of ascites coexisting with ovarian tumor
and was so reported by Dr. T. Gaillard Thomas in
his paper on the " Diagnosis of Malignant Dis-
eases of the Ovaries."
"Case xxvin. — A multilocular ovarian tumor
mistaken for a case of ' ascites, complicated with
ovarian tumor;'' tapped six times, ovariotomy.
April 13th, 1 87 1, Dr. W. K. Brown, of Brooklyn,
New York, called at my office to consult me about
a case of abdominal tumor. From the very intelli-
gent account rendered by him, I inferred that it
was a case of multilocular ovarian tumor, and re-
quested him, when the case was again tapped, to
send me, by express, a specimen of the fluid. *
* During my absence the patient was tapped, a
portion of the fluid was received and examined by
Dr. Drysdale, and decided to be ovarian. On my
return from California on the 3d of June, I found a
letter from Dr. Brown, urging me to visit Brooklyn,
to operate on his patient. Dr. Thomas had seen
the case Nov. 20th, 1870, and tapped her the same
day, removing four gallons of dark-green, syrup-
like fluid. She was tapped again — -six times in all.
After each tapping, a solid tumor could be detected
occupying the right side, circumscribed, movable,
and not tender on pressure. Dr. Atlee's diagnosis
was ; ' a multilocular ovarian tumor, with one large
cyst occupying nearly the whole cavity of the abdo-
men.' The operation confirmed the diagnosis.
' The fluid was contained in one large, thin-walled,
ovarian cyst, which was adherent to the walls of the
abdomen. A large multilocular mass occupied the
right side of the abdominal cavity.' There was no
ascites."
Dr. Atlee's remarks on this case are well directed.
" I have not presented the above case with the most
remote idea of criticising the valuable paper of Dr.
Thomas, but merely to show how so astute and ac-
curate an observer may be led into error, as well as
to call attention to one or two methods by which
such an error might have been avoided. So far as I
can comprehend Dr. Thomas' opinion it is this : that
a large accumulation of ascitic fluid with a compara-
tively small ovarian tumor is indicative of malig-
nant disease of the ovary. In confirmation of this
opinion he cites five cases of dropsy, one of which
is the case above reported. With regard to this
case he says : ' When I saw her, this accumulation
was so immense as to cause her great pain and in-
convenience from distension. Dyspnoea from pres-
sure against the diaphragm was especially marked.
In this case, as in case fourth, I was struck by the
fact that in dorsal decubitus no point of resonance
could be discovered upon percussion over the abdo-
men, which I attributed to the excessive amount of
effusion. To make more certain a diagnosis at
which I had even now partially arrived, I obtained
Dr. B's consent to paracentesis, and drew off seve-
ral large pailfuls of straw-colored serum.' It is
just at this point that I wish to make an observa-
tion regarding the diagnosis in this case and in all
other cases where i the fluid is suspected of accu-
mulating in such large amounts as to force aside
the super-natent intestines, and produce dullness in
place of resonance on percussion in dorsal decubi-
tus.' Now, the object of the tapping, in such
cases, is 'to make more certain the diagnosis,'
and there are two methods by which this can be
satisfactorily accomplished: First, by continuing
to percuss the abdomen as the fluid is escaping. As
the fluid diminishes in amount, if contained in the
peritoneal cavity, the intestines will sooner or later
float upon it unless bound down by adhesions, and
a resonant percussion sound will be returned
which will be manifested in the most elevated points
on every change in the position of the body ; but
if the fluid is encysted, the resonant sound will be
stationary. * * * Second, the diagnosis can be
made more certain by the physical and microscopical
character of the fluid. Sometimes the physical
character alone will decide the question, but when
it is a ' straw-colored serum,' resembling ordinary
ascitic fluid, the examination by the microscope
will determine its real nature and its true source,
by detecting or not detecting the peculiar ovarian
granular cell."
Our space is too limited for further extracts. We
commend the work in the highest terms as the best
on the subject, and one that should occupy a place
in the library of every physician.
The Annual Report of the Board of
Health, of the Health Department of the City of
New York, for the year ending March 30th, 1872,
long delayed by unavoidable circumstances, is now
passing through the press. One hundred pages
had been printed, but were burned in the fire
which recently destroyed the Express office. It will
form a volume of some 400 pages, octavo ; and,
besides the usual official reports of the several
bureaus, will contain certain appendices of great in-
terest to the medical profession, and to sanitarians.
Among these we may mention an interesting report
on "The Cerebro-Spinal Meningitis Epidemic" of
1872, by Morean Morris, M. D., late City Sanitary
Inspector ; illustrated with map and engravings ;
a report on " The Small-Pox Epidemic of 187 1-2,"
by a Committee of the Sanitary Inspectors, giving
some of the results and statistics of the work of the
department in the management of that disease ; a
paper, by Commissioner Stephen Smith, M. D., on
" Movements of Tenement-House Populations"
(elsewhere referred to), and another, by the same
gentleman, on " Summer Mortalities," fully illus-
trated by charts, etc.
Several sanitary works are in course of prepa-
ration, and will probably be published in the early
part of the present year. Among them will be a /
little monograph on " House Drainage, Sewerage
and Water Supply," by Henry R. Stiles, M. D.,
and James Ingram, both of whom are attached to
the Board of Health ; the former as Health Inspec-
tor, the latter as Assistant Engineer. The work,
The Medical Union,
21
which is very practical in its character, will treat of
the nature, construction, and structural defects of
the many domestic appliances common to the
dwellings of the present day, such as water-closets,
soil-pipes, sinks, privies, etc., etc. ; and is designed
to show especially the intimate relation between
such defects and many forms of disease. The expe-
rience of the authors and official opportunities which
they enjoy of examining into this subject, can
scarcely fail to render the book of great value and
practical interest to both laymen and professional
men.
Another monograph on the Ventilation, Heating,
and Interior Sanitary Construction of Houses, may
also be expected from the pen of another of the
City Sanitary Inspectors.
Dr. Hamilton has in preparation a practical
work entitled "Practical Electro Therapeutics"
Dr. Hamilton is at the head of the State Hospital
for the treatment of nervous diseases in this city,
and his work is a record of personal experience
such as cannot fail to be of great service to those of
his professional brethren, who have less opportunity
for practical acquaintance with this remedial agent.
{Transactions of Societies,
THE MEDICAL SCIENCE ASSOCIATION.
[Abstract of Minutes, Dec. ioth, 1872.]
The President, Dr. Egbert Guernsey, called
the meeting to order.
Intermittent Fever. — The experience of Dr. Blu-
menthal in the use of beberine as a remedy for
this disease had been very satisfactory. He had
used it in the ordinary allopathic doses, and had
also given it in the homoeopathic attenuations, his
best and quickest results being obtained from the
sixth attenuation. While residing in New Jersey
he treated a number of cases of intermittent fever.
His attention was at one time called officially, as
chairman of a committee from the State Society,
to the practice of a physician who was said to be
very successful in their treatment, but was charged
with using "secret remedies."
The charge proved to be unfounded. The
treatment was as follows : The patient was treated
with quinine and tartar-emetic powders, each pow-
der containing half a grain of quinine and an eighth
of a grain of tartar-emetic. These powders were
taken three times a day until the intermittent fever
subsided, and then, for ten days afterward, a daily
powder of arsenicum 1st was given. Dr. Blumen-
THALhad used this prescription himself and thought
well of it, although he preferred smaller doses and
single remedies.
Dr. Minor thought the proportion of tartar-
emetic was too large, and that troublesome nausea
and vomiting would be produced in a majority of
cases by the administration of an eighth of a grain
three times a day.
Dr. Egbert Guernsey relied principally upon
quinine. He does not consider the objections
of some to the use of quinine, on the ground that
patients so treated do not " stay cured," are well
founded.
In his experience, quinine cures were as radical
cures as any others. He has known those who were
reported cured by the potencies to relapse again,
and a certain proportion of relapses may be ex-
pected under'any treatment ; but no remedy has, in
his hands, produced such quick, permanent and
satisfactory results as quinine.
Dr. Hallock cured a case, several years ago,
with natrum mur., 200. He was called in consul-
tation to the case by Dr. J. G, Baldwin, The low
potencies had been already used unsuccessfully, and
it was concluded to try the high potencies. Natrum
mur. was indicated, and one dose of the 200th po-
tency given. The patient never had another chill.
The doctor mentioned this case not as illustrating
his practice — for he rarely uses the high potencies — -
but as an interesting cure that astonished both pa-
tient and physician.
THE QUESTION OF DOSE.
Dr. Doughty related some cases of syphilitic
periostitis, in which the pain and cachexia had been
removed by large doses of iodide of potassium, from
twenty to sixty grains three times a day.
The question was raised whether this treatment
was homoeopathic.
Dr. Brown, in reply to the question, considered
the treatment just related as strictly homoeopathic.
The provings of iodide of potassium show that ca-
chexia, articular swellings, pains in the bones, and
many of the symptoms peculiar to the secondary
and tertiary forms of syphilis, are produced by this
drug. When the drug cures or relieves those symp-
toms, it does so in accordance with the homoeopathic
law, no matter what the dose maybe. "Similia
similibus curantur" is a law of cure, and not a law
of dose; the question of dose is a matter for indi-
vidual experience to determine.
MERCURIAL POISONING IN DENTAL PRACTICE.
Dr. Minor presented to the Pathological collec-
tion of the Association an inferior maxillary bone
which he had excised. The case was one of necro-
sis following the application of arsenic for the pur-
pose of killing the nerve. The point, however, to
which the attention of the Association was directed,
was the occurrence of salivation, produced by the
insertion of an amalgam filling into a tooth when
the surrounding parts were inflamed and vascular.
He asked the experience of the members as to the
effects observed from amalgam fillings, and from the
use of artificial teeth supported by rubber plates.
Dr. W. N. Guernsey knew of three reported
cases of salivation produced by amalgam fillings.
Dr. Blumenthal had seen three cases in his own
practice where the use of artificial teeth with rub-
ber plates had produced symptoms of mercurial
poisoning.
Dr. Rickaby had met with one case like those
mentioned by Dr. Blumenthal.
Dr. E. Guernsey could refer to six cases where
the rubber plates had been the cause of trouble to
the wearer on account of the mercury contained in
the plates.
THE ACTION OF QUININE AND ERGOT ON
THE UTERUS.
Dr. W. N. Guernsey reported the following
case : Recently he saw, in consultation, a woman,
aged 37, the mother of ten children, the youngest
of whom was two years old, who sought medical
aid for a swelling at the seat of an old ventral hernia.
It had not attracted her attention until three weeks
oo
The Medical Union.
previously. She had noticed none of the usual
signs of pregnancy ; there was no discoloration of the
areola around the nipple, no abnormal sensation in
the breasts, and her menses had been perfectly reg-
ular until the last, which commenced three weeks
before, and had not ceased to flow.
There was noticeable a round, prominent tumor in
the subumbilical region, which was movable, and
the hand could be pressed below it against the spinal
column.
Conjoining a vaginal examination with the ab-
dominal palpation, the tumor was diagnosed to be
an impregnated womb, which probably contained a
foetus of three and a half months. As the haemor-
rhage was profuse, and the os internum considerably
dilated, secale cornutum was advised to be given in
frequently repeated doses.
The physician in charge reported three days
afterward no change in the symptoms. Dr. Guern-
sey then recommended quinine in grain doses. In
one half hour after the administration of the first
dose, strong uterine pains commenced, and within
three hours the foetus and placenta were expelled,
both of which showed evidences of commencing
decomposition. The secale used was.Squibb's fluid
Extract.
There were three points of interest : the delusive
history, the preternatural mobility of the uterus,
and the prompt and effective action of quinine as a
uterine stimulant.
During the past year, the attention of the profes-
sion has been occasionally called to the usefulness
of quinine in promoting uterine contractions. One
writer has spoken highly of its use in parturition,
considering it more reliable than ergot.
Dr. E. Guernsey had often seen good results
obtained by quinine in menorrhagia arising from
an atonic condition of the uterus.
Dr. W. N. Guernsey referred to the use of ergot
in arresting threatened abortion. He narrated a
case reported by Dr. A. K. Gardner where abortion
seemed imminent ; and opium, subacetate of lead,
and absolute rest had been of no avail in arresting the
pain and haemorrhage. As the haemorrhage was
profuse, and life seemed at stake, secale was given
with the intent of emptying the uterine cavity. To
his astonishment, pain and haemorrhage ceased, and
at full term the mother gave birth to a healthy child.
In reply to the question asked by Dr. Blumenthal,
if secale in large doses acted in these cases under
the law of " similia similibus curantur," Dr. E.
Guernsey mentioned several instances of its arrest-
ing uterine contractions. He said it acted quickly
either to excite or to arrest them. Dr. Hallock
said his experience with the drug coincided with
that of Dr. Guernsey.
Public Health Association of New York.
— A series of informal meetings held during the
summer months of 1872 resulted in the organiza-
tion of an association of individuals interested in
sanitary studies. The following gentlemen took
part in these preliminary meetings and became
members of the organization, viz.: Charles F.
Chandler, Ph. D.; Carl PfeifTer, Augustus Viele,
M. D.; Elisha Harris, M. D.; Stephen Smith, M.
D.; Edward H. Janes, M. D.; Chas. P. Russel,
M. D.; Henry R. Stiles, M. D.; Nicholas L. Camp-
bell, M. D.; Admiram Judson, M. D. On the
15th of August, 1872, this association was formally
organized by the adoption of a constitution and the
election of the following officers : President,
Stephen Smith, M. D.; Vice-President, Chas. F.
Chandler, Ph. D.; Recording Secretary, A. B.
Judson, M. D.; Corresponding Secretary, Carl
Pfeiffer ; Treasurer, E. H. Janes, M. D.; Chair-
man of Executive Committee, Elisha Harris, M. D.
The objects of the association are " the advance-
ment of sanitary science and the promotion of
organizations and measures for the practical appli-
cation of public hygiene ;" its membership is open
to all, of whatever profession or calling, who have
an " interest in or devotion to sanitary studies, and
allied sciences, and to the practical application of
the same."
September 20th, at the society's first regular
scientific meeting, an exceedingly interesting paper
was read by the President, Dr. Stephen Smith, on
" The Movements of Tenement-House Populations
in New York City, with suggestions as to methods of
preventing overcrowding and of providing the
laboring-classes with improved dwellings." The
reading of the paper (which, we understand, is to
be published in an enlarged form in the forthcom-
ing report of the New York Board of Health) was
followed by an exceedingly interesting description
by Mr. Lorin Blodgett, of Philadelphia, of the
system of building small and cheap homes for the
working-classes in that city ; and also by some re-
marks on English tenement-houses by Mr. W. E.
Worthen. Miss Dr. Mary C. Putnam and Dr. H.
R. Stiles also contributed to the discussion of the
subject.
October 30th, at a regular meeting, a paper was
read by the President on " Sanitary Legislation,
Organization and Work in the City of New York. "
At a public meeting held in the Chapel of the
Reformed Church, corner of Fifth avenue and
Twenty-ninth street, on the evening of December
7th, an elaborate and thoughtful paper was read
by Dorman B. Eaton, Esq., former Counsel to
the Metropolitan Board of Health, on " Sanitary
Legislation in England and New York." Mr. Eaton
was the framer, in a great measure, of the Met-
ropolitan Health Law, virtually the same as the
present law ; and his intimate acquaintance with the
subject, enlarged by careful study of English and
foreign health legislation during his recent pro-
longed absence abroad, rendered the paper one of
great interest and value. It will probably be pub-
lished in full by the association. Mr. George W.
Hastings, general secretary of the British Social
Science Association, gave a detailed and graphic
statement of the nature and operation of the "Con-
tagious Diseases Act" in England. His earnest
and forcible presentation of its results, as derived
from his personal experience as one of the Royal
Commission appointed to investigate the workings
of the act, was listened to with the deepest interest
by the large audience assembled, among whom we
noticed many of the leading sanitarians, health-
officials, &c, of New York and Brooklyn.
December 12th, regular meeting. The evening
was well occupied in the discussion of current san-
itary topics.
The association now numbers twenty-four resi- v
dent members, embracing gentlemen of various
professions, such as lawyers, doctors, architects,
scientific students, &c, and bids fair to enjoy the
success which its object so greatly demands.
The Medical Union.
23
We are pleased to see that the claims of sanitary
science and public hygiene have been recognized by
the Faculty of the New York Homoeopathic Col-
lege, who have provided for a course of special lec-
tures on those subjects in the current^session of the
college. Dr. Henry R. Stiles, one of the Health
Inspectors of the city (and formerly connected with
the old Metropolitan Board in Brooklyn), has been
lecturing to the students on sanitary topics, with
marked success.
Scientific Cleanings,
Garotting at Guy's Hospital. — We read in
the Guy's Hospital Gazette, of a class of cases
which in the opinion and according to the practice
of the writer, "are benefited by being garotted."
" One night," this gentleman relates, " going round
the wards I found a girl in a hysterical fit; she
fought and struggled vigorously with her nurses.
Hating all rows, I grasped her throat and held it
firmly till the astonished girl gasped out, ' You are
choking me ! ' I then relaxed my" hold and prom-
ised her a repetition of the performance. She was
thoroughly cowed after having two more fits, and,
being twice nearly choked, her alarm was so great
that, though every night previously she had had
fits, she desisted, and in a month afterwards her
mother told me with joy of her complete recovery.
A few days later Mr. Stocker, whose experience is
immense, told me how beneficial this plan was, and
said, ' You may remain for hours fighting with a
screaming girl, but carefully choke them and they
immediately subside — it is unpleasant for them, it
frightens theni.'" The italics tare those of the ac-
complished proficient in the art of choking. It is
a great pity that this valuable contribution to medi-
cal science is not entirely complete. In case the par-
oxysm is not controlled by the patient being "nearly
choked," we would naturally infer, and it is indeed
very reasonable to suppose, that success would
crown our efforts if we carried the treatment a
little farther and quite"\ choked the patient. The
muscular doctor will be glad to know that the same
principle has been lately carried out in the New
York Hospital, where the approved method was to
tear off the clothes of the patient, prick her with
lancets, drag her around the room and beat her.
The case treated thus in the New York Hospital
also recovered, but her mother did not come back
"with joy" to tell about it, although the treatment
was, no doubt, "unpleasant." In the Lunatic
Asylum, on Ward's Island, the same treatment
has been carried out even more thoroughly. The
cases permanently cured have all been buried, and
those under treatment are doing as well as could
be expected. We suggest to the Governors of the
New York Hospital, and to the Commissioners of
Charity, that a professional garotter be added to
the medical staff of all our hospitals, and that Mr.
Stocker, "whose experience is immense," be in-
duced to communicate his views to the profession at
large as to the best methods of quieting nervous
excitement.
A New Method of Treating Ulcers is de-
scribed by Mr. Cowan in The Lancet. " Knowing
as we do," says the author, " that an ulcer has the
power of absorbing matters applied to its surface
(any one can try the experiment with black- wash to
a moderate sized ulcer for a few days, when mercu-
rial salivation will begin), it occurred to me to avail
myself of so excellent a property by applying
locally matters having nutritive powers, so that the
skin might be nourished locally at the weakened
and degenerate spots, to enable the skin to take up
such material as would nourish its weakness, and
convert its brittle state into a plastic and healing
one. The natural secretion of an ulcer, the so-
called laudable pus, may it not be a nourishing
juice specially thrown out to feed the young grow-
ing granulations ? If so can we not add to this by
artificial manuring?
Such is the theory, and accordingly the doctor
puts his famished ulcers on a nourishing diet as
follows :
"Flour, four ounces; powder of acacia, one
ounce ; powder of tragacanth, half an ounce ; one
egg; chalk, two drachms; cold water, one pint."
These ingredients are to be thoroughly mixed and
placed in a saucepan over the fire. As soon as it
boils, or a minute or two after, it is to be removed
from the fire. It must be thin enough to spread
over the ulcer on a brush, and thick enough to
remain on the ulcer. If the directions given yield
too thick a paste, a little boiling water may be used
to thin it. Each patient is provided with a small
bottle and brush, and is directed to paint his ulcer
all over three or four times a day, and keep it cov-
ered with a soft piece of rag. No other treatment
is required. The patient should come for a fresh
supply of the paste every day, and the bottle and
brush should be washed out daily in order to keep
them fresh and sweet. This treatment has the
merit of being simple, rational and painless, and,
according to the author, is more efficacious than the
usual methods. A number of cases are given show-
ing that in its author's hands this method succeeded
in some cases of long standing after the failure of
other means, skin-grafting included.
Atmospheric Wave. — By a careful examina-
tion of the reports as received from the signal
stations located on or near the Pacific coast, it
appears that on the 12th of November, an atmos-
pheric wave, similar to that which makes its annual
appearance on the coast of England and Western
Europe, began to break over the shores of Oregon
and British Columbia. By the evening of the 12th
it had spread over nearly the Pacific States and
Territories, and at midnight was passing through
the gorges of the Rocky Mountains, descending
in turn, upon Colorado, Nebraska, Kansas and
the Indian Territory. On Friday, the 15th, its
eastern limit marked a course from Washington
Territory on the north to the Lower Mississippi
Valley on the south. Should this wave of air,
which in the date and method of its approach so
closely resembles the English one, continue, like
that, in a series of successive undulations for several
months, its presence will serve to account for our
American winter storms, showing that they have
their origin in the Rocky Mountains, where the
moist air from the coast encounters and is condensed
by the cold dry atmosphere of the mountain sum-
mits, the result being those overwhelming snow
storms that are the dread of the Western traveler.
This would seem to prove the correctness of the
theory that our cold weather comes from the West
instead of the North.
24
The Medical Union.
Disinfectants. — In the Central Chemical De-
partment of Public Health at Dresden, numerous
researches have been recently made with various
disinfectants. The value of chloride of lime and
sulphuric acid, which form the most effectual dis-
infecting material, is here given by ioo, while the
remaining numbers show the value of the other
materials as compared with this standard :
Chloride of lime, with sulphuric acid ioo
" " sulphate of iron 99.0
Luder and liedloff powder 92.0
Slaked lime 84.6
Carbolic acid, disinfecting powder 85.6
Alum 80.4
Sulphate of iron 76.7
Chloralum 74.0
Sulphate magnesia 57.1
Termany fat with sulph. acid 51.0
Contagion. — M. Kletzinsky, noticing that per-
sons sick with small-pox were often visited by flies,
placed near an open window of the hospital, a
saucer filled with glycerine. The flies gathered
about it and were caught like birds with glue. In
endeavoring to free themselves, the foreign matter
adhering to them was left in the glycerine, which
was carefully examined by the microscope. The
glycerine was found to be full of strange cells, simi-
lar to those seen by persons attacked with small-
pox, but never found on the fly. This discovery
shows that flies can be a very dangerous means of
spreading contagious disease.
The annual meeting of the British Homoeopathic
Congress was held at York, on the 4th of Septem-
ber. In addition to the president's address, papers
were read : " In what way is the action of drugs to
be discovered? " by Dr. Sharpe ; "On the plan and
value ofbaptisia in the treatment of typhoid fever "
by Dr. Hughes; and, u On the physiological action
of serpent poison," by Dr. Tybner. We have not
space for the report of the discussions, or these
papers, which were full and interesting.
Intermittent Fever. — Dr. Dujardio Beau-
metz speaks highly of carbozotate of ammonia in
the treatment of intermittent fever, from one-third
to two-thirds of a grain daily being sufficient to sup-
press the paroxysms. Like quinine, it diminishes
the strength of the pulse and induces languor,
cephalgia and even delirium, and finally is eliminat-
ed from the kidneys. In many cases where quinine
had failed, the drug worked a speedy cure.
Chloral in Sea-Sickness. — Dr. Ogilvie Will
says, in a severe voyage across the Atlantic he gave
chloral in eighteen cases of sea-sickness, and in only
one did the drug fail to produce relief. He gives
thirty grains in sweetened water, directing the dose
to be repeated if relief does not follow in twenty
minutes. He advises a little light, easily-digested
food to be taken before sailing, and directs the
choral to be taken and the patient to lie down on
the first symptoms of the sickness presenting them-
selves.
Antiquities. — In Egypt, mummies have been
found with teeth filled with gold, and in Quito a
skeleton has been found with false teeth secured
to the cheek bone by a gold wire.
In the museum at Naples, among some of the
surgical instruments discovered at Pompeii, there is
a fac simile of Sims' speculum.
Hews 3tem$>
The Brooklyn LYiNG-In Asylum is negoti-
ating for a new building. The lady managers pro-
pose establishing, in connection with this institution,
a nursery, a dispensary for the treatment of diseases
of women, and a school for nurses.
The Hahnemann Hospital of New York has
broken ground for its new building. This hospital
will cover ten lots (half a block) on Fourth avenue,
between Sixty-eighth and Sixty-ninth streets.
Dr. Albert E. Sumner has recently been ap-
pointed a member of the Brooklyn Board of Exam-
ining Surgeons for Pensions, and has been elected
Secretary of the Board.
Dr. H. M. Paine, of Albany, writes : " We are
about starting a homoeopathic hospital here; one
has just been organized in Buffalo."
The Brooklyn Homoeopathic Hospital will
be formally opened about the first of January,
1873.
Dr. William M. Guernsey has been appointed
Physician to the Home for the Friendless, in place
of Dr. C. T. Liebold, resigned.
Dr. Verona has received the appointment of
Resident Physician of the Brooklyn Lying-In
Asylum.
Dr. H. B. Cole is expected to return soon from
Vienna to take the position of House Surgeon in
the Brooklyn Homoeopathic Hospital.
The New York Ophthalmic Hospital was
formally opened Dec. 16th, 1872.
iDbituary*
Dr. Jacob Beakley, the founder of the New
York Homoeopathic Medical College, and until the
past two years its Professor of Surgery and Dean of
the Faculty, died at the residence of his brother,
Dr. Henry Beakley, at Peekskill, in September last,
in the 61st year of his age. Dr. Beakley was one
of the earliest homoeopaths in this city, embracing
its doctrines and advocating them with zeal at a
time when it required some courage to enter the
ranks of a school comparatively new, and with but
few adherents, exposing himself to the ridicule and
sneers of old friends and professional associates. In
a short time he obtained a lucrative practice. This
he afterward relinquished in accepting the position
of Professor of Surgery in the Homoeopathic Col-
lege but recently established in Philadelphia. In a
few years he dissolved his connection with this
school, and by his own energy, and in a great
measure at his own private expense, started the
college in New York. His students, now scattered
all over the country and doing good service in the
ranks of our profession, and in nobly upholding the
standard of medical reform, will remember him /
only with feelings of tenderness. The good he has
done lives after him. The seed he has sown has
already ripened into a rich harvest. Who is there,
remembering his own fallibility, will cast a stone on
the new-made grave ?
The Medical Union.
25
iDriginal Articles.
PETROLEUM-ITS ORIGIN AND RELATION TO
MEDICINE.
By Robert A. Chesebrough.
Petroleum is one of the most curious, as well as
one of the most interesting, of the spontaneous pro-
ductions of the earth. It seems to have been well
known to the ancient Greeks and Romans, and to
have been used by them for various purposes;
Tacitus, Pliny and Vitruvius mention it, and Herodo-
tus refers to a spring of bituminous liquid flowing
in Zacinthus, one of the Ionian islands, two thousand
years ago, and it is probable the spring had existed
for a long period before his time. Bakoo, on the
borders of the Caspian Sea, and the Ragoon dis-
trict on the Irrawaddy, are remarkable for their large
yield of petroleum from ancient times. From the
latter source the Burman Empire and India have
been furnished with vast supplies of oil for an un-
known period, amounting at one time, it is said by
Symes (Embassy to Ava), to an annual yield of 400, 000
hogsheads from some 500 wells. It seems to have
been principally used in a crude state in lamps for
lighting, for preserving timber against insects, and
as a medicine. Large supplies have been more re-
cently obtained in Italy, in Southern Russia, and
the history of its discovery and the enormous yield
obtained in the United States are too recent and
well known to need repetition here. The origin of
petroleum seems to be exceedingly obscure, and no
satisfactory solution of its formation has as yet been
given to the world. While some authorities have
considered it as of volcanic origin, basing this
opinion on its being found in volcanic districts, others
have deemed it to be a drainage, as it were, from
the cannel and bituminous coal measures, which
coal yields on distillation an oil similar in character
and elements to the natural earth oil. Near Vesu-
vius a spring of petroleum rises up through the sea,
and around the volcanic isles of Cape Verd it is seen
floating on the water. But although petroleum is
obtained in proximity to the coal measures, it is also
found in geological formations where coal does not
exist, in fact it is oftener so found; and again, where
the most prolific of oil-yielding coals in the world
have been found, viz: the Boghead of Scotland
and the Albert of New Brunswick, no trace of petro-
leum has been discovered. In Canada West, bor-
dering the Lakes, large deposits of petroleum
occur lying near the surface, and this in a district
outside of the coal limits. It has also been main-
tained that petroleum was the result of vegetable
organic decay, but the main basis for this theory is
the accepted starting point that it emanates from
coal ; but if we discard this source of production, as
the proofs would seem to oblige us to do, this theory
is left without support. Certainly, petroleum pre-
sents in itself no evidence of being of vegetable
origin, its characteristics and elements are entirely
different, and though we allow that the distillates of
cannel coal are similar, there is much more reason
to deny that cannel coal results from organic decay
than to admit that origin for petroleum.
Petroleum is composed of hydrogen and carbon,
the proportions of which differ according to its den-
sity or body, the heavier oil containing the most car-
bon. It will not absorb oxygen, and does not, there-
fore, as do all known oils or animal substances, oxy-
dize or decompose in time or from exposure.
In the deep wells of Pennsylvania the crude oil
found is exceedingly light in body, is highly inflam-
mable, and of a spirit-like nature, showing a large
excess of hydrogen, while the oil obtained in West
Virginia from shallow wells possesses a far greater
viscidity, is not at all inflammable, and shows an ex-
cess of carbon. By boring deep wells in the same re-
gion, light oil is obtained similar to the Pennsylvania,
and it holds good as a rule all over the world, that the
heavy oil is found near to the surface, while the light
oil is obtained at a considerably greater distance be-
low ; and when found on the surface it becomes by
exposure, bitumen or asphaltum, having parted, by
evaporation, with nearly all its hydrogen. Now,
there can be no doubt, and it is universally con-
ceded, that these oils of different density were
originally the same, all proceeding from the oil of
light gravity, distilled down, as it were, by the nat-
ural heat of the earth, or from exposure on the sur-
face. As a proof of this fact, if we take a large
kettle of light gravity petroleum, place fire under-
neath and slowly evaporate it, the oil in the kettle
gradually becomes denser and assumes the character
and appearance of the heavy crude oil ; then as the
process is continued, it appears like bitumen, then it
becomes a lustrous solid asphaltum, and finally when
evaporated to perfect dryness, the residuum bears a
striking resemblance to cannel coal.
It is with extreme diffidence and caution that we
venture to uphold a theory greatly at variance with
the teachings of modern geology, but when in defence
of these teachings the proof offered is chiefly negative
and the reasoning abstract, and on the other hand the
proof seems direct, and, to us, the reasoning con-
clusive, it is in the interest of true science that the
merits of both should be investigated. We are
taught by the geologist that coal has been formed in
the earth from vegetable decay, that vast forests
swept down by time and the convulsions of nature
have left their remains congealed and compressed
in the shape of coal deposits. By what chemical
process organic fibrous matter has been changed
into compact masses of hydrogen and carbon is not
explained, nor why coal lies in veins and drawn out
seams, rather than in vast tracts or huge pockets as
it would seem natural it should do, were this theory
the true one, we are not told. Undoubtedly, peat
is the result of vegetable decay ; it bears every evi-
dence of its origin. It lies as the forests fell, in large
tracts, never running out into seams or lines as do
the coal measures, is dissimilar in all respects to
coal, and is not found in the coal districts. It has
been held that coal was the ultimate result of peat,
but there is an absence of all proof to sustain this,
and the accepted theory of the coal formations suf-
ficiently refutes such a conclusion. The geological
formation necessary to the production of coal is ab-
sent in the peat deposits, and underlying the coal
deposits is found the sandstone formation, which is
wanting under the peat beds. In fact, the appear-
ance, localities, products and characteristics of the
two substances show an entire dissimilarity. Geolo-
gists agree in classing the different varieties of coal,
viz : the cannel, bituminous, and anthracite as one
series, of identical origin, only evaporated down by
heat and time to different degrees of dryness ; and
there can be no doubt but that this is true. On the
26
The Medical Union.
James River, near Richmond, Va. , there is a natural
bed of coke, underlying which and interspersed with
trap rock and apparently baked fire-clay is a layer
of coal, under this a deposit of half-coked coal, and
still farther down a layer of bituminous coal. By
subjecting bituminous coal to artificial heat we have,
as an ultimate result, coke, but by subjecting peat to
artificial heat we have, as an ultimate result, char-
coal, similar in structure to wood charcoal, thus
clearly showing its organic parentage, and indicat-
ing the contrary for coal. Now, if coal is not a de-
posit of organic matter, what is it ? We answer,
we believe it to be solidified petroleum, and claim
that the proofs to sustain this belief seem direct and
conclusive, while we can discover no evidence in
contradiction. Let us look for a moment at a few
of these proofs, as we call them.
First : Petroleum evidently runs in veins or streams
in the earth, filling up the chinks and cracks in the
sandstone formation, in which it is found, which seems
to be necessary to its retention, and from which it is
extracted by wells of varying depth. The striking of
one well contiguous to another has often resulted in
drawing off the supply of oil from its neighbor, thus
proving that the two wells tapped the same stream.
Originally, nearly all the wells yielding oil of light
gravity in Pennsylvania were at first flowing wells.
Now a flowing well is a great exception, and the
reason is obvious. The district is honeycombed
with well-holes, and the pent up gas which forced
the oil to the surface has escaped, thus clearly dem-
onstrating that the supply below runs in communi-
cating streams, branching off in different courses.
A glance at the coal seams will exhibit identical
features. These seams or veins wind through the
earth like small streams, here and there branching
off from the main artery and ending in small
pockets, and sometimes returning to it in uncertain
and wayward courses, just as though these streams
had originally been liquid and had forced their way
wherever they could find vent. Underneath these
seams lies the same sandstone which retains the pe-
troleum, forming now the bed of the coal. As the
petroleum veins lie at varying depths, being forced
up by the pressure beneath into the cracks and
breaks of the sandstone, so likewise lie the coal
veins, some near to the surface, others far beneath
it. To account for the meandering veins of coal on
the assumption that they were once liquid seems
easy, while to account for the mystery of vegetable
deposits being (in the instance of coal alone) drawn
out into long, thin sinuous lines, with no traces of
these remains on either side of these lines, seems
difficult indeed.
Second : The great and principal strength of the
vegetable theory, we may say its very groundwork,
is the fact that organic remains have been found
imbedded in the coal measures. Large stems of
the calamites occur frequently in the sandstone.
Club mosses and ferns in endless variety are found
in the coal, preserving their original shape as though
moulded and hardened in clay, their vegetable
origin being plainly apparent. But this fact, to our
mind, is a weakness of the vegetable theory, and a
confirmation rather than a refutation of our argu-
ment. Why should the process which converted
organic remains into a solid mass of coal have spared
some of these remains from this great change ? The
law which was good as to the great mass was good
as to the whole, unless some exceptionable con-
dition overruling this law, as to these unchanged
parts, can be shown. On our theory, the explana-
tion of their occurrence is easy. The streams of
petroleum in their courses through the crevices of
the rock carried with them plants and trees im-
mersed in their liquid, the bulk of which vegetable
matter probably became in time dissolved and ab-
sorbed into the body of the bitumen itself, while
some of it became petrified as the fluid hardened
into a solid, and was thus preserved in the shape
these remains present to-day. In the great up-
heavals which the earth's crust has been subjected
to through the past ages, it could not be expected
that these then half liquid streams of bitumen should
remain pure and unmixed with vegetable matter.
On the contrary, it seems strange that they are so
pure and uncontaminated, and their lines and courses
so plainly marked.
Third: Coal, like petroleum, is composed of hy-
drogen and carbon, the cannel and bituminous
series presenting on distillation similar products to
those of petroleum, while vegetable structures do
not yield analogous products, either in their original
condition or through their undisputed remains in
the shape of peat.
Fourth : If it is true, as is universally conceded,
that anthracite coal was formerly bituminous, baked
to dryness in the earth, and the bituminous was
originally cannel similarly evaporated, we accom-
plish a vast stride in our theory, for the step from
bitumen to cannel coal is a slight one, and it is
equally well established that bitumen, or asphaltum,
is evaporated petroleum. We have then but to
establish the connection between bitumen and can-
nel coal and the chain becomes complete. Twice
has this identical question been the subject of im-
portant law suits. In 1853 a case was tried in
Edinburgh, involving the right to mine the Boghead
beds, which were leased as coal. On the trial the
most eminent authorities, in their testimony, differed
as to whether the substance was coal or bitumen.
A similar case was subsequently tried in New Bruns-
wick, involving the title to the Albert mine, the
question turning on the same issue In both cases
the deposits were held to be coal, but the opposite
was strongly maintained by experts of high charac-
ter, who classed them as bitumens. That the equity
of the proceedings lay with the holders of the leases,
rather than with the contestants who sought to in-
validate them on technical grounds, may have had
much to do with the verdicts of the juries, seems
probable. At all events, the distinction between
coal and bitumen was found to be so narrow as to
involve much uncertainty, and had at that time pe-
troleum been known to the Western world as an
article of commerce, as it is to-day, and the origin
of bitumen itself been as well understood as it now
is, the two substances in contest might have been
held to be identical.
Fifth : We shall close our proofs by pointing to an
instance of the occurrence of bitumen and coal in
one deposit. In the island of Trinidad, West Indies,
is a lake of petroleum bitumen about a mile and a
half in circumference, which is underlaid by a bed
of coal. The bitumen on the surface is hard and
dry, being baked by the hot sun of a tropical clime,
but underneath it is soft and oily, showing its petro-
leum origin.
To sum up our theory succinctly, we claim that
petroleum of the lightest density is the parent of
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27
the coal measures, and from it proceeds, in regular
gradation, heavy petroleum bitumen and asphaltum,
then the coals, cannel, bituminous and anthracite,
and then coke. On the other hand, we claim that
peat is the result of organic decay, and its ultimate
result is charcoal.
Now, it is in no wise necessary to the support of
our theory that we should show what petroleum is,
and of what formed, if it is not, as claimed, the re-
sult of organic decay ; for the secret of its forma-
tion might remain forever an unsolved mystery,
without detracting anything from our argument.
We may suppose, if we will, that it is an original
substance, existing in vast supply in the earth's inte-
rior ; or we may more reasonably assume that by some
mysterious process, hydrogen eliminated from water,
acting on and combining with the carbon of the
rock, aided by heat and pressure, forms petroleum,
and that this process is going on continually, and has
been going on forever in the great laboratory of the
earth. We have here the two constituents of petro-
leum, hydrogen and carbon, both existing in unlim-
ited extent in the water and rock. We know that
by the aid of heat water can be decomposed and its
hydrogen set free, and we have therefore but to
suppose this liberated hydrogen as dissolving and
combining with the carbon of certain rocks to rea-
sonably account for petroleum. Certainly this latter
part of the process is mysterious, but nature is full
of mysteries far more wonderful and inexplicable
than this, and we submit that this chemical combi-
nation would be less wonderful than the production
of either coal or petroleum from organic remains.
[Lack of space obliges us to transfer the consid-
eration of the Medical Properties of Petroleum to
another number of the Union.]
THE DUTY OF THE STATE IN THE PREVEN-
TION OF DISEASE.
By Egbert Guernsey, M. D.
In studying the future of our country, two points
are strongly impressed upon our mind. First, the
decrease in the ratio of births in our population ;
and, second, the enormous percentage of deaths
under five years of age. Both of these points are
matters for grave consideration.
To establish the first, we have only to look at the
census returns since the establishment of our na-
tional government. We find by the census of 1 830
the number of white children in the United States
under fifteen years of age to every one thousand
females between the ages of fifteen and fifty were,
in Alabama, 2,591 ; in 1840, 2,508; in 1850, 2,071,
and 1,973 in i860. There were in Massachusetts
1,368 in 1830; in 1840, 1,258; in 1850, 1,143, and
in i860, 1,123. In. New York there were in 1830,
1,837; in 1840, 1,580; in 1850, 1,364, and in i860,
1,327. In Kentucky there were in 1830, 2,279; m
1840, 2,201 ; in 1850, 2,003, and in i860, 1,906. In
Illinois in 1830 there were 2,580; in 1840, 2,280;
in 1850, 2,035, and in i860, 1,822. These States,
taken at random from the different parts of the
Union, fairly represent the general decrease in the
percentage of births. Were this decrease in the
percentage of births counterbalanced by a corres-
ponding decrease of deaths in infancy and early
childhood, showing an increase of vigor and vitality
during that period, it might be a question if the
nation and humanity were not gainers by the
change. But this is not the case. It is a reproach
to our profession that with all its boasted resources,
with all its wealth of means, which an all-wise
Providence has placed within its reach, in a land
where but few are poor, and where all, with but
little exertion, unless stricken down by sickness, can
easily obtain a comfortable livelihood, that death
should reap its richest harvest from infancy and
early childhood. It is a reproach to the statesman
having the interest of the nation at heart, that he
has forgotten that the real wealth of a nation con-
sists not in its forts bristling with cannon, not in
its armed ships floating on every sea, but in the phys-
ical and intellectual strength of the people, their
freedom from disease, and their power to people
the land with a strong and vigorous growth. It is
a reproach to the Christian and philanthropist that
they have not struck boldly and with a strong hand
at the great social evils of the day, and have learned
the all-important fact that, as a rule, to have pure
and noble lives, they must have healthy physical
organizations.
Crime is often the result of disease. The un-
harmonious, nervous and mental organizations
which fill our prisons and scaffolds, are often
produced by disobedience of hygienic laws, which
causes the stream of life to flow on tainted and
tainting from generation to generation. These
errors and violations of Nature's laws cause not
only much of the crime which fills the land, but that
terrible mortality in childhood through which nearly
one-half born into the world perish before they
reach the age of five years.
Of the 393,606 deaths recorded as occurring in the
United States for the year ending June 1st, i860,
168,852, nearly one-half, occurred under five years
of age ; and nearly one-fourth of the whole num-
ber under one year. In 1870, of the 481,243 deaths
which occurred in the United States, 203,213 died
before they reached the age of five years. In 1872,
in the city of New York, 50 per cent, of the total
mortality was in children less than five years old.
At the close of the sixteenth century, according
to Marshall's tables, one-half of all children born
perished under five years of age, and the average
length of life of the whole population was eighteen
years. Notwithstanding the average expectation of
life at birth has been increased to about forty-eight,
the decrease in the mortality of children under five
years, as will be seen by the figures already given,
has been very slight. In Boston, in 1870, the deaths
of children under five years of age reached forty-
three per cent, of the whole mortality. In 1871,
the percentage of deaths under one year was, in
Boston, 27; in Baltimore, 28.90; Brooklyn, 25.
25 ; New York (1869), 20.42 ; Philadelphia, 24.85 ;
Washington, 28.30. According to Wappaens, in
Europe, 33.66 per cent, of the entire population are
below fifteen years of age, thus being consumers
only, and contributing nothing directly to the pub-
lic wealth. A sound political economy, viewing it
from no higher stand-point, demands that infancy
and childhood shall be so far protected and sur-
rounded by safeguards, that the large majority shall
not only pass the period of helplessness until they
can become producers as well as consumers, but
that they shall be well protected so that they may
28
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come upon the stage of action with healthy physical
development.
There is a greater loss to the community than
from the fcdeath of consumers before they reach
the productive age. It is from that vast stream
of diseased and vicious humanity which is con-
stantly flowing into society from the fountain of
childhood, too often tainted and corrupt, breathing
its malarious poison wherever it goes. Incompe-
tent nursing, scanty feeding, a vitiated atmosphere,
give rise often, if they pass the period of childhood,
to feeble and crippled men and women, who become
more or less a weight upon society all their lives.
Money spent in educating children into strong and
healthy men and women is more than saved in
hospitals and prisons.
The attention of the State, then, should be in-
telligently and earnestly directed, as a matter of
political economy, looking to the strength, stability,
and physical and intellectual wealth of the nation,
to the means of prolonging the lives of that vast
throng which^swells the tide of death in early child-
hood ; and not only in prolonging their lives, but
so protecting them and surrounding them with such
safeguards in education and judicious nourishment
that they step out upon the stage of action with a
physical and mental development which will enable
them to do^their part intelligently and well in the
greatToattle of life.
In large cities the mortality is, of course, im-
mensely greater among the poor — among those
who live in cellars, in single rooms and in small
apartments, in closely confined tenement houses.
From these quarters the death list is the heaviest,
and the hospitals and nurseries draw their principal
supply. , Some are driven to these quarters by mis-
fortune, but in their apartments you will find, how-
ever poor they may be, however barren their rooms
may be of comfort, an attempt at least at cleanli-
ness. But in the great majority the finer feelings of
nature seem to have been blotted out by their con-
tact, year after year, with that filth and misery in
which often they and their fathers have lived gener-
ation after generation. Here into these nurseries of
vice, and crime, and sickness, and death, society
should step — that society which shines in silks and
diamonds at charity balls — that society which rears
our marble churches^and weeps over the destitution
of the heathen in foreign lands, and sends its gold
m liberal supply for their conversion. These efforts
are all noble in themselves, and we would not draw
one drop from that broad and thirsty stream of liv-
ing charity which has done and is doing so much
for ^humanity. But let this society step in with its
strong voice, nts Vealth, its intellect, its refinement,
well directed and guarded by that comprehensive
wisdom which in other matters has done so much
for .humanity, so much for the wealth and prosperity
of the nation. Let it, through proper authorities,
control and direct sanitary affairs, not with a spas-
modic,'feverishjimpulse, wrought up almost to frenzy
by some glaring wrong which has forced itself upon
its notice, but with a broad, comprehensive policy
well matured, in which the resources of science shall
be brought to its^aid, and the whole entrusted to able
and honest men, willing to carry out its commands
in their spirit and integrity — men whom no desire
for pecuniary gain can swerve from their high sense
of duty. More than this, let them be held to a strict
account for the manner in which they perform then-
work. Let the street-cleaning contractor, the rail-
road corporations, with their ill-ventilated and over-
crowded cars, know that they are amenable to law,
and that the law means the protection and safety of
the public. Let every tenement house be so erected
as to give light, fresh air and the means of cleanli-
ness to all, and through sanitary officers compel the
observance of sanitary rules. There are hundreds
and thousands in large cities who, unless they are
prevented by the strong hand of the law, will herd
together and live like swine. It is not enough to
require by law physicians to report contagious cases
of disease. This, as far as it goes, is right, and is
undoubtedly the means of preventing a large amount
of sickness. But what we want is a law, properly
executed, which will compel the erection of houses
where it is possible for people to live without being
poisoned by foul air. It is true, an attempt has been
made to carry out some of these provisions ; but go
among some of the lower class of tenement popu-
lation and see whether it has been anything more
than an attempt.
We have adverted to the lack or non-enforcement
of the necessary sanitary regulations in the erection
of tenements for the poor, and in the absence of
sufficient care to compel an observance of proper
hygienic rules as a fruitful cause of the immense
fatality among children, and in the diseased and
feeble constitutions among adults of that class in
our large cities. If we pass to the public hospitals,
we find the same lack of care, the same system of
crowding, and the absence of that broad system of
Christian benevolence which should characterize the
management of public institutions. The idea seems
to be, here are only paupers, who should be thank-
ful if a great city, with untold wealth, should give
them a place to die, and dole out its food and
warmth to them in the smallest proportions. When
from twelve to fifteen hundred poor lunatics are
crowded within a space only intended for five hun-
dred, as has often been the case on BlackwelPs
Island, what can physicians do, however skillful and
willing to perform their whole duty ? What is the
use of their theorizing about nourishing food and
careful attendance, and warm and well ventilated
rooms, when, if the city authorities do not econo-
mize in these minor matters, there will not be suffi-
k cient money to fill the pockets of the Tweeds and
" Sweeneys, and all those noble men who, for years
past, have done so much for the honor of our city.
On that sunny slope on Ward's Island there is a
broad field, seamed with deep trenches, into which
are cast by hundreds and thousands the nameless
paupers. Hurry them out of sight.
" Rattle their bones over the stones,
They are only paupers, whom nobody owns."
And a day's support is an item to the great city.
And the little children,
" Who are weary ere they run,
Who have never seen the sunshine nor the glory,
Which is brighter than the sun,"
find these trenches the gateway to greener fields,
where there is no hunger and no tears.
Are we too strong in our language ? Will the
facts be denied, that in the charity hospitals and
asylums and nurseries on the Island, including
Bellevue Hospital, there is a lack of that care and
attention which the suffering poor and helpless
The Medical Union.
29
children have a right to expect at our hands ? The
public have not forgotten how in the new Insane
Asylum, but a few months since, helpless lunatics
were abused and kicked and trampled upon by
beastly and brutal nurses. They have not for-
gotten, either, that the physician at the head of
the institution, who would not cover up this bru-
tality, who would not wink at this wholesale torture
and murder, is found to be in the way, and loses
his place in the institution. He knows too much,
and, poor man, his conscience is too tender. He
has not yet forgotten the obligations of his oath,
that grand old Hippocratic oath.
The whole system of nurses is wrong. Men and
women are selected as attendants upon the sick and
helpless, not for any qualification they may pos-
sess for the work, but because political friends wish
to find places for them ; and so, ignorant, brutal at-
tendants fill the places where should only be found
the skilled and the trained. These abuses exist not
alone in our institutions in New York, but all over
the country ; in almost every city and town where
the poor are cared for at the public expense, there
is more or less the same lack of care, the same in-
competency in attendance, the same desire to spend
money in costly buildings, and save in the care of
the inmates. Do our profession suppose they have
fulfilled their duties to society in simply prescribing
for the sick when called upon, and in closing their
eyes to glaring abuses ? They have been baptized
to a work second only in importance to the care of
souls, the care of the public health. It is their
duty not only to lift the warning voice against
abuses wherever found, but to search them out and
suggest the remedy. It is their duty to demand of
the public authorities that the positions of attend-
ants upon the poor, the sick and helpless, be given,
not as reward for political services, but to trained
and skillful nurses.
To the Christian, the philanthropist, the states-
man, to good citizens everywhere, the question de-
mands attention, " How shall this terrible tide of
disease and death in childhood be stayed ?"
We are in the midst now of a whirlwind of po-
litical reform. Political rings have been broken up,
and unjust judges deposed. Is it too much to ask
of our legislators to look into this question which so
vitally affects the future of our country ?
We need more stringent enactments, in reference
to the sanitary affairs of large cities. A law, placed
in proper hands for execution, which shall prevent
the erection of unhealthy dwellings, and which
shall compel due observation of sanitary laws.
We need a training school for nurses of both
sexes, and the absolute necessity of every appointee
in our public institutions having received some pre-
liminary instruction, proved by careful examination,
before entering upon his duties. Every medical
college should have a department for the careful
instruction of nurses. If our female medical col-
leges would direct more attention to this one de-
partment, sending out skillfully trained nurses, and
giving their certificates only to those of good moral
character, thousands of children might be saved,
and they would receive the thanks of mothers every-
where. Break up the medical rings in our public
institutions, which are often more arbitrary and ty-
rannical than the worst and most corrupt political
rings, giving the appointment of the medical and
surgical staff to the Mayor, to be chosen from those,
in his judgment, best qualified for the position.
Let no school be ostracized, and scientific attain-
ment and fitness for the position be the test, rather
than adherence to any particular medical dogma.
Let the assistant surgeons and physicians be selected
from those students of the highest rank in scholar-
ship, on a fair examination, without compelling
them to show a diploma from some sectarian allo-
pathic college. Let the nurses also be appointed
only after a careful examination, without regard to
political favoritism ; and all, steward, superintend-
ent, assistant physicians, and nurses, be subject to
the direction of the medical and surgical staff. Let
it be distinctly understood that our hospitals are for
the benefit of the sick, that they are sent there to
be relieved, and, if possible, cured, not to be mur-
dered, that a few students may become better posted
in diagnosis. It is perfectly right that the immense
clinical material in our hospitals should contribute to
the instruction of our profession, but this only
should be done judiciously, and without endanger-
ing the lives of the patients.
In these times of reform, we call upon our legis-
lators to look earnestly at this question of the waste
of human life, and devise some means by which
this useless expenditure can be saved. Let each
State look carefully at its sanitary regulations, and
see that they are made in the interest of no sect
and no class, but only of the public good.
But we need something more than this, we need
a national sanitary system, whose influence shall
penetrate and be felt in every city and town and
hamlet through the length and breadth of the land,
from ocean to ocean. Let there be a body of men
appointed by the President, selected solely with re-
gard to fitness for the position, without regard to
party or sect, selected from the ablest and most
practical scientists in the land, not mere theorists,
but men who are capable of devising and putting
in force a grand and comprehensive sanitary sys-
tem. Earnest men all over the country would come
to their aid with valuable information and useful
suggestions. The Signal Service Bureau is already
in telegraphic correspondence with every section of
the country, and so admirably is the system ar-
ranged that atmospheric disturbance, not only on
the land, but on the sea, can be predicted with al-
most unerring certainty, and the track of storms,
or damp and chilly winds marked out. Connect
this information, thus easily obtained, with the
development of diseases in different localities, the
structure of the soil, the drainage, the vegetable
productions, and geological formation, and all local
causes of sickness so far as can be obtained, and
we should have a mass of information brought
together where it could be systematized, the proper
deductions drawn, and rules and directions given,
by means of which not only epidemics could be
checked in their march of death, but informa-
tion given as it regards the food and clothing and
early care of children, which would yearly preserve
thousands of lives.
If the appointment of this organization were made
by the President, and to it by act of Congress given
the necessary authority to carry out a broad and
comprehensive plan, it would be placed above party
or sectarian influence, and work solely for the pub-
lic good. We again repeat, the strength of the
State is in the physical and mental strength of its
people. The great mission of the State and hu-
3<>
The Medical Union.
manity is to protect, elevate, and make happy and
harmonious the lives of the people. We implore
our legislators to look carefully and earnestly at
these matters ; the duty of the State to the poor
and helpless, and to the prevention of disease and
death.
OVARIOTOMY.
MONOCYSTIC TUMOR CONTAINING TWO GALLONS
OF FLUID — INCISION TWO INCHES LONG —
LIGATURES BROUGHT OUTSIDE THE WOUND
— RECOVERY.
By John C. Minor, M. D.
In November, 1872, I was called to the case of
Mrs. M. She was thirty-one years of age, married,
the mother of four children, and in good physical
condition, with the exception of an enlargement of
the abdomen, that had given her some trouble pre-
viously, and which prevented her from performing
her duties as housekeeper. About a month before
I saw her, she had suffered from what seemed to be
an attack of circumscribed peritonitis, attacking the
left inguinal region. The abdominal enlargement
had been first observed two years and a half before,
appearing to begin on the left side, and gradually
filling up the abdomen. My examination revealed
the presence of a large ovarian cyst, shaped some-
what like a pear, with the smaller end toward the
right side. In the left inguinal region, when the
abdominal walls were moved over the surface of the
tumor, a crepitant feeling was communicated to the
hand, as though there were adhesions between the
sac of the tumor and the abdominal wall. The
lumbar regions were equally dull on botiTsides.
The uterus was high up in the pelvis, somewhat
retroverted, and in a position of lateral version, so
that the fundus was toward the right and the cer-
vix toward the left side. On simple inspection of
the abdomen, the tumor seemed to consist of two
irregular portions, the larger division being on the
left side, separated by a deep sulcus from the smaller
portion on the right. On percussion, however, the
fluctuation was equally distinct and uninterrupted
throughout every portion of the tumor. It is un-
necessary to go through the other details of the ex-
amination, which presented nothing but the ordi-
nary signs of the presence of an ovarian tumor. It
was mainly on the basis of the facts already described
that I diagnosed the case as one of monocystic. dis-
ease of the left ovary, with recent adhesions between
the sac of the tumor and the peritoneum in the left
inguinal region. (Ifproved to be the right ovary
that was affected, as will be seen from the opera-
tion. ) Although the distension was such as to give
the appearance of one at the full period of utero-
gestation, there was no oedema of the lower extremi-
ties ; the menstrual functions were regular, and her
general condition of mind and body was such as to
warrant a favorable prognosis in the case.
Operation.— November 6th, 1872, I removed the
tumor at the New York Medical College and Hos-
pital for Women, before the class of students. Drs.
A. K. Gardiner, C. S. Lozier, F. E. Doughty, H. C.
Houghton and others were present, and contributed
valuable assistance. The patient having been
brought under the influence of chloroform and her
bladder emptied, a short incision of two inches was
made in the median line, midway between the um-
bilicus and pubes, down to the tumor. A sound
was swept around the tumor, and no adhesions of
importance detected. I immediately plunged a full
sized trocar into the tumor, and evacuated its con-
tents— two gallons of coffee-colored fluid. The col-
lapsed tumor was now drawn out through the in-
cision, and separated from its adhesions. One of
the adhesions — the fimbriated extremity of the
fallopian tube, on the left side — required a ligature,
torsion failing to arrest the bleeding. The pedical,
which was short but thin, was tied with a single
ligature, and the tumor was cut off and removed.
The remaining ovary (the left) was examined, and
found to be congested ; but as this condition was in
all probability physiological, there seemed to be
nothing that required surgical interference. No
fluid having escaped into the abdominal cavity, no
sponging was needed. One end of the ligatures
was cut short, and the other brought out at the
lower part of the wound. The wound was now
closed with two quilled sutures of silver wire and
five superficial sutures of fine silk, the quilled sutures
being passed through the entire thickness of the ab-
dominal wall, and including the peritoneum. The
part was dressed with patent lint, saturated with a
solution of carbolic acid in glycerine (1 part of the
pure acid to 50 parts of glycerine) ; this was covered
with cotton batting, and the whole by an abdominal
bandage. She was now lifted from the operating
table and placed in bed, with hot bottles at her
feet.
An examination of the tumor showed that the
lobular form was caused by a fibrous band in the
anterior wall of the cyst, constricting that part of
the tumor into two unequal portions.
The following notes are copied from my case
book :
Subsequent History. — Nov. 6th. — The patient re-
acted well. There was no pain at the seat of opera-
tion, but she complained of some slight pains in the
small of the back and in the hips. I directed that
the wound be dressed twice a day, and that the
catheter be used every six hours. A few hours after
operation, vomiting began, for which I prescribed
nux-vomica (tinct.).
Nov. yth. — The patient had no sleep last night,
on account of the vomiting, which nux-vomica
failed to check. To relieve that condition, I or-
dered kreasote 3d to be administered every two
hours. Her appearance this morning was good ;
pulse 100, and tongue coated. At night, finding
the vomiting still continuing, I gave her one-sixth
of a grain of codeine, which immediately controlled
it, and gave her the first sleep since the operation.
Nov. 8th. — Slept well last night ; vomiting gone;
free from pain ; feels hungry. The wound appears
to be healing by first intention. Ordered a light
diet and no medicine.
Nov. gth. — The patient had a slight chill to-day,
with transient stitches of pain across the abdomen.
Appearance good. No medicine.
Nov. nth. — Began menstruating. This accounts
for the congested appearance of the remaining ovary
noticed during the operation.
Nov. 13th. — Removed the sutures ; wound healed I
by first intention.
Nov. i$th. — The patient had a natural movement
of the bowels this morning. Has taken her meals
sitting up in bed since the 13th inst.
The Medical Union.
3i
Nov. 2$tk. — Has been able to sit up during the
day since the 17th inst. Is now able to walk about
the room. I used slight traction on the ligatures
to-day, without loosening them.
Nov. 27th. — The patient was discharged to-day,
cured. The ligatures, however, still remain.
Since the last entry in my case book, I have seen
the patient several times, and have removed one of
the ligatures. The other still remains (Jan. 18th,
1873), but would probably come away without much
difficulty if I chose to remove it. The patient is in
perfect health, and able to work as well as ever.
No. 10 East Forty-first street.
iCorrespcmbence,
A WORD OF ADVICE TO STUDENTS ABOUT
TO GRADUATE.
In my last letter I entered upon some antiqua-
rian vagaries with the intention of continuing
the subject in this month's issue of the journal.
But it has since occurred to me that the pre-
sent number of the Union would make its ap-
pearance just at • the time when so many of our
young friends are about to enter upon their profes-
' sional career as Doctors in Medicine (God help
them !) and that I might very properly let the
things of the past take care of themselves for the
present and devote this epistle to the things of the
future. I therefore address myself to the graduating
class of medical students, and take as my text the
question so often asked by students of each other —
" What do you propose to do after graduating ?"
No matter how rich or how poor you may be, the
question of your future success in the profession will
be decided, in a great measure, by your mental de-
velopment during the first few years of your profes-
sional life. If you depend upon your present stock
of medical knowledge to carry you through your fu-
ture career you will stand but a poor chance of at-
taining anything more than a position of barren
mediocrity in the profession. On the amount of
knowledge and expertness acquired during the first
five years of your professional life will depend, for the
most part, all that can stimulate a doctor's ambition.
As it is so important then for you to take a long
look ahead and start right, I will consider the pro-
posed question by laying before you three courses to
pursue, viz. : 1. Beginning private practice at once.
2. Entering a hospital. 3. Completing your studies
abroad.
1. If you begin practice at once you will do so
either alone or in connection with some older physi-
cian. If alone, you will have abundant time for
study, and let me advise you to use it for that pur-
pose. Take up some study that has not been
thoroughly taught in your college and work at it till
you are proficient and expert in it. In this way you
can become skillful in the use of the microscope and
chemical tests. If you have the opportunity of at-
tending a dispensary, seize the chance that is there
given to use the ophthalmoscope and the laryngo-
scope, for, in the use of these instruments, you can
make no satisfactory progress unless you have, besides
your books, a sufficient amount of material to prac-
tice upon. Study French and German in order to
avail yourself of the wealth of medical literature that
will otherwise be known to you at second-hand, if at
all. Put yourself in the way of all available clinical
instruction whether in dispensary, hospital or col-
lege. Devote the rest of your time to practice. So
much in regard to your most important work. And
now, perhaps, you would like my opinion as to your
financial prospects for the first few years of practice.
Very few young doctors are able to make both ends
meet, until they have been in practice for three or
four years, unless they possess exceptional advant-
ages either in location, association or education.
You may safely expect to be rich in expenses and
poor in income for three years, and as to making
both ends meet, it will be anything but amusing to
contemplate the alacrity with which those "ends"
will dodge each other all the while. If you begin
practice in the city, your expenses will be greater
and your patients fewer than would occur in a coun-
try practice, and it is far better for you to begin
practice in the country, and end in the city, than to
follow the reverse order. It is not always a good
plan to be associated with an older physician, for you
will always be called his " assistant," and there is a
great deal in a name. My advice is to be indepen-
dent from the start. If you hesitate because you are
young, and fear that none will employ you, go away
from the city, a thousand miles if necessary, and
find some locality where a doctor is needed and
where you may be sure of plenty of work however
unremunerative. But wherever you are, don't fail to
work in the direction I have indicated, for sooner or
later an opportunity will occur to take a higher posi-
tion, and the question will be decided by your ac-
tual development and not by your possible ability to
make up for lost time.
2. Hospital practice is, in the end, a better way
of occupying your time immediately after gradua-
tion t£an private practice. The time thus used is
not, in any sense, lost time ; for the experience and
maturity of judgment thus acquired will put you
ahead in your subsequent private practice faster than
you could have progressed without these advantages.
In hospital service you will be able to perfect your-
self in physical diagnosis, to become practically ac-
quainted with the most recent investigations in
pathology, and to avail yourself of daily clinical in-
struction. You will become in a short time familiar
with innumerable details of practice and with the
newest developments of medical science. I believe
that two years of intelligent service in a large hos-
pital will teach you more than you could learn in
five years of active private practice. It will give
you an opportunity of seeing some of the best and
some of the worst practice extant, and if you can
keep an intelligent and discriminating observation
on all the abundance of material spread before you,
the opportunities of hospital service will be priceless.
But the moment you begin to lose your head ; to
indulge in admiration of men rather than measures ;
to be enchanted with the boldness and dexterity of an
operator without a careful weighing of the results of
an operation, that moment you are lost to the real
advantages of hospital service. For the sum and
substance of your opportunities lies in the cultivation
of a sound and unbiased judgment, without which
the eye, the ear, and the hand will be trained to no
purpose. In order to enter a hospital, however, you
32
The Medical Uniott.
must first pass the required examination. The posi-
tions are few in number and the candidates are
legion. It is notorious that these positions are as
often obtained by favor and influence as by merit,
and it is therefore possible that, however well quali-
fied you may be, the doors of the hospital may be
closed against you. I therefore ask your considera-
tion of the third plan — the pursuit of your studies
abroad.
3. The best course for you to pursue is to start at
once for Vienna, and begin there the completion of
your studies. The expense of this plan is not much
more than you would incur by staying at home —
$1,000 (gold) a year will be sufficient for you if you
can practice economy, but $1200 or $1500 a year
will be a fairer estimate, for the prices of living in
Vienna have nearly doubled in view of the ap-
proaching Exposition, and what would have cost
$700 three years ago can hardly be obtained now
for $1200. If you are not already familiar with the
language, you can spend the time necessary to learn
it in some less expensive place than Vienna. And
what can you learn at the Vienna school that is
worth all this time and expense ?
Let me picture a day's work in Vienna and then
compare it with anything you can do in New York.
At 9 a. m. you attend Hebra's Clinic on Diseases of
the Skin, famous all the world over for the wonder-
ful variety of cases and the value of the lectures.
Arlt's Eye Clinic occupies your time profitably from
10 to 11 o'clock, and at 11 o'clock you attend that
Laryngoscopic Clinic of Professor Stork, over which
the Vienna medical students go nearly crazy in their
enthusiasm. Every day you will have the oppor-
tunity of examining ten or fifteen patients in this
clinic, and of treating at least four or five of them
by blowing in powdered tannin or alum ; by pencil-
ing with solution of nitrate of silver ; by cauterizing
with the coated sound, or by using whatever means
may be indicated. A wonderfully good practical
course it is, where the wretched patients are so poor
they dare not complain when you sear the
whole back of the tongue and pharynx an ugly
white in the vain endeavor to touch a given spot on
the arytenoid cartilages or vocal chords with the
cautery probe. Such opportunities can only be had
in Vienna where so much value is placed upon the
progress of science, and so little on the comfort or
life of the patient. At 12 o'clock you can have an
hour in Sigmund's Syphilis wards, under his able
assistant, Dr. Griinfeld. This is another excellent
course, consisting of a lecture at the bedside, and the
treatment of ten or a dozen patients. One day it
is held in the male and the next in the female
wards. Allowing you some time for dinner and
digestion, 3 o'clock would perhaps be soon enough
to go with your four companions for an hour's
private instruction by Jaeger on the operative sur-
gery of the eye. Sometimes the cadaver is used,
and sometimes you perform the operation on pig's
eyes set in a mask. (When you go to your rooms
at night, remember to take half a dozen eyes with
you, and go over the day's operation with a mask. )
At 6 o'clock you may finish up the day's work by
an hour's instruction from Bergmeister, Arlt's assist-
ant, in the use of the ophthalmoscope.
Your day is ended, and I have mentioned only a
limited number of courses. Each course lasts five
weeks, and then a new one begins. You can select
any subject you choose to work up — surgery, ob-
stetrics, diseases of the lungs, heart, bladder, his-
tology, pathology — in fact, anything you want, and
take any number of private courses in it until you
are satisfied with your proficiency. In these private
courses only a few are instructed at a time, because
too many in a class would interfere with your prog-
ress. These courses are not gratuitous, but are
paid for. It would, perhaps, interest you to hear
about Billroth, Rokitansky, Bamberger and others
famous in the medical world, but I believe enough
has been said to show you that medical teaching,
such as you can get in Vienna, is very different
from any instruction you have yet received, and in-
comparably more valuable. If you can afford the
time and money, it would be well for you to spend
your third year in Paris, and at least six months in
London.
Now, having set before you three courses to pur-
sue, let me urge you, by all means, to follow this
last one, if it is possible for you to do so. In itself
it can be made a cheap or an expensive plan, ac-
cording to your own ability to economize. Its re-
sult, if followed, will be to make you self-reliant,
because you are conscious of knowledge ; success-
ful, because you leave your first mistakes in Europe ;
and well recommended because the name of having
studied abroad will be presumptive evidence that
you are competent in your profession. It will affect
your standing at once, not only in your private
practice but in your professional relations, and fairly
open to you the brightest prospects of a high posi-
tion in the ranks of our fraternity. That you may
succeed in that calling, however hard the first few
years may be, and that knowledge and experience
may bring you at the same time a broad and liberal
spirit in all professional matters, is the sincere hope
and wish of John Crannell.
A LETTER FROM VIENNA.
I.
The imperfect system of medical education ex-
isting at the present day in our country, renders
necessary some sort of after-training, before the
newly-fledged " M. D." can, with a clear conscience,
undertake the responsibilities and perplexities of his
profession.
This, his first professional experience, may be
gained in two ways, namely, by serving his time in
one of our own hospitals, or by studying at some of
those in Europe. But, of the large number of
graduates who yearly leave our schools, compara-
tively few can be accommodated at our home insti-
tutions ; hence, the large majority of those who feel
the imperative necessity of some more practical
knowledge of the art of healing than they already
possess must seek it abroad.
Besides this class of students, there exists another
— physicians who have already been in practice some
years, and begin to feel the need of getting out of
the routine habits which all are so likely to form — of
going through the process known as " brushing up,"
and bringing themselves abreast of the age. The
wants of these two classes differ not in kind, but in
degree ; and the remedy applicable in the former
case will be found to answer admirably in the latter.
The run abroad decided upon, the first question
which naturally arises in the student's mind is,
" Where can I dispose of my time to the greatest
advantage ?" It is, in the main, with a view to an-
The Medical Union.
33
swering, however imperfectly, this important ques-
tion, that I now write.
Without hesitation, I should say that, for the pur-
poses mentioned, the Vienna school offers advant-
ages unequaled by any other, whether we consider
the wants of the special or general practitioner, and
for the following reasons, viz. : ist — The fact that
the enormous amount of material furnished by this
city and vicinity is collected, for the most part, in
one large General Hospital (Allgemeine Kranken-
haus), thus enabling the student, if he so chooses,
to occupy every minute of his time by profitable
work, instead of having to run from one hospital to
another, perhaps a mile or more distant, as in Lon-
don and Paris. And, 2nd — The unequaled number
and excellence of the private courses (to my mind
the most perfect means of instruction), not to speak
of the clinics.
These two arguments in favor of the Vienna school
are, I believe, not disputed, and, though many
others might be given, are sufficient, I think, to
substantiate the claims I have made for its superiority.
Another is sometimes adduced, however, namely —
the number of celebrities who teach here. But this
seems to me not of such very great practical impor-
tance ; and I may as well tell why. Billroth, Hebra,
Sigmund, Bamberger, Jaeger, Arlt, Rokitansky,
Strieker, Gruber, are all good names — and there are
many more ; but, from a practical point of view,
are we (a class of ten or fifteen, say,) not going to
learn much more concerning disease and its man-
agement, by going through the wards and having
each case thoroughly investigated and explained to
us by an able assistant, than by simply being present
at one of the great clinics, with two hundred others,
only the front row of whom can see the patients at
all well ? To be sure, where it is possible we should
follow both the clinics and private "courses ; but it is
not always to be done. Then the question arises, as
practical physicians or surgeons, which is of the more
importance to us — the private course, where we may
see the same patients as in the clinic, handle them,
see them treated, and at the same time hear the
theories of the Professor enunciated by his assistant,
or the clinic, where, if we even see the patient well,
we must be the fortunate owners of front seats ?
I find I have made something of a digression, but
it is not, I hope, without its practical bearings, and
hence may be borne with.
As regards the other great schools of Europe,
the London hospitals possess, undoubtedly, more
material than the Vienna General Hospital, and the
clinics are, perhaps, better conducted than at the
latter.
Less can be said of Paris — but both there and in
London there is much to see and many world-
renowned authors and teachers to listen to ; and if
one makes the best use of his time, a winter spent in
either capital must bring its reward.
Berlin has much to recommend it ; the names of
Virchow, Langenbeck and Traube, being sufficient,
if there were no other reasons, to establish its repu-
tation as a first-class school.
Nevertheless, as compared with Vienna, the dis-
advantages already named exist in all three of these
places, viz. : the waste of time in getting from one
hospital to another, and (which I consider the
greater) the impossibility of obtaining private in-
struction, in small classes, in every branch of medi-
cine, as may be done in Vienna.
The smaller schools of Edinburgh, Wurtzburg,
Dublin, Heidelberg, &c. — though excellent, each in
its own way — need not, I presume, be admitted as
rivals of their larger brothers already mentioned.
The advisability of visiting all these places, how-
ever, and observing how they differ with one another
in their modes of teaching and practice, is, of course,
too potent to be discussed. But for him who is not
able to do this — who has, say, but a winter before
him, and wishes to do the greatest amount of work
possible in that period, whether in general or special
study — Vienna is, I am confident, the school par
excellence.
The opportunities offered here to the student are
something wonderful, and, I fear, are not sufficiently
appreciated by us at home.
To give an example of what a specialist may do
here in one day, let us suppose our student to be an
Ophthalmotologist. From 8 to 10 A. M. he attends
Prof. Jaeger's clinic, and from 10 to 12 Prof. Arlt's.
His afternoon duties begin with the private course
on diseases of the eye, given by Dr. Schnabel
(Jaeger's assistant), at 2 P. M. At 3 he takes
Jaeger's private course on ophthalmic operations,
and finishes the day with two (if he chooses) courses,
one succeeding the other, from 5 to 7 P. M., on the
ophthalmoscope, given by Dr. Bergmeister, Prof.
Arlt's assistant. Besides these, he may take two or
three other courses if he prefers them to those al-
ready named. Thus he is able to do from six to
eight hours of good work in his specialty daily;
with which, if he is a reasonable man, he should be
satisfied. Where else could he do as much ? Nearly
as much might be said for the other branches — skin,
ear, throat, venereal, &c. As for him who attempts
to follow as far as he can be led, I pity him ! He
may begin work at 7 A. M. with Prof. Hyrtl's lecture
on anatomy. Continuing throughout the day his at-
tendance at the various clinics and private courses —
he may remain all night in the obstetric wards — and
thus spending, literally, every hour of the twenty-
four in study, have, notwithstanding, the melan-
choly fact stare him in the face, that he has not seen
all, as many of the clinics, &c. , are held at the same
hour. It is needless to remark that very few thus
take advantage of all the opportunities offered.
The limits of a letter do not allow of full justice
being done to the merits of Vienna as a place of
study. And, as it seems to me, there is much to
interest your readers in some accounts of the modes
of teaching and leech-ing here, I have ventured to
address this to you as an introduction to, rather than
a pen-picture of, the subject.
In my next letter I will endeavor to be more ex-
plicit in describing some of the workings of this
great educational machine. M.
Vienna, January, 1873.
Longevity. — During the year 1872, twelve cen-
tenarians died in Philadelphia — Isaac Shivers, 100 ;
Hugh Finley and Anna Margaret Turner, 101 ; Ed-
ward P. Vollum, 102 ; Michael Ferry, 103 ; Mar-
garet Amos, 105 ; Mary Loquaire, 107. Mrs.
Temperance Jewett, widow of the late Dr. Jeremiah
Jewett, and sister of the mother of the late George
Peabody, died at Barnstead, N. H., recently, aged
100 years and seven months. Mrs. Mary Snyder,
said to be aged 108, died lately at Leesville, Craw-
ford Co,, Pa.
34
The Medical Union.
DR. RICORD ON SYPHILIS.
At a recent meeting of the British Medical Asso-
ciation at Birmingham, Dr. Ricord, of Paris, was
present, and on the invitation of the society gave a
summary of his views upon Syphilis. Dr. Ricord,
by his long course of scientific investigation and his
vast practical experience as chief of one of the
largest hospitals in Europe, has cast more light up-
on the pathology and treatment of Syphilis than
any other man living, and his ripe experience as
embodied in this article will prove of great value
and interest. We have tried to condense it, but
have been unable to take out a single word, and
therefore present it entire as it fell from his lips.
Many of our readers may not be aware that Dr.
Ricord, by birth and early education, is an American.
He was born in Baltimore, in 1800, where he re-
mained until 1820, when he went to Paris, and
received his first degree in 1826. In 183 1, he be-
came Surgeon-in-chief of the Hospital du midi at
Paris. He is an officer of the legion of honor and
is honored with the decorations of many European
orders.
There was one great question in regard to syphilis,
and it was this : could it be cured radically ? In form-
er times all venereal affections, no matter what, were
considered as belonging to syphilis, and certainly
there was then an immense number of radical cures
by mercury or any other means. In this way swell-
ings of the glands, soft chancres, even warts, and
other things not belonging to syphilis, were easily
enough cured, radically cured; and there were
no after-consequences, no secondary symptoms.
This explanation would account for the immensely
large number of cases of (reputed) syphilis which
used to be radically cured. But, since syphilis had
been correctly diagnosed, the inquiry to which he
had devoted a large part of his life was to see what
belonged to syphilis, and what resembled it without
belonging to it. There had been great differences
in the results of treatment — so much so that a
doubt, as Mr. Acton had said, had arisen whether
real syphilis could be cured. That doubt as to the
curability of syphilis was not recent ; it was a doubt
which old authors had expressed ; and one particu-
larly, with a curious name, which they would prob-
ably remember — " Mercurialis " — thought that now
and then an armistice might probably be made with
syphilis, but that there was no real cure. In fact,
they frequently saw that a long time — months,
years — after the symptoms had been treated, new
symptoms appeared. And so the doubt whether
syphilis could be radically cured, or whether the
cure was only temporary, with a prospect of the
symptoms returning, might still remain ; he (Ricord),
however, had established the law of the unicity of
the diathesis of syphilis. The law of syphilis was
the same as the law of small-pox, cow-pox, or
measles. A man could have but one attack so long
as the disease remained in the constitution — that
was to say, according to his opinion a new attack
could not take place while the system was still under
the influence of the old diathesis. Well, it was
exactly so with syphilis ; as long as a patient was
laboring under the diathesis of syphilis, another
infection of syphilis could not occur — it was impos-
sible. For instance, after indurated chancre, and
the appearance of secondary symptoms, it was not
possible for the patient to contract a new indurated
chancre, with swelling of the glands, manifestation
of skin disease, and so on. After one attack the pa-
tient could not have another infection as long as the
influence of the first remained in his body ; a sec-
ond contagion could not take possession of the
system at the same time. If, perchance, something
of the kind took place, the symptoms would not
follow the regular evolution. So, when a patient
had constitutional syphilis, if a new chancre ap-
peared to be hardened, they would not find the
glands swell, or the early manifestation of skin dis-
ease appear ; and so of other symptoms. Superficial
ulceration might take place, just as a spurious form
of vaccination might arise on one who was still un-
der the vaccine influence ; but it was not a true case,
it was not attended with the sequelae. But if the
constitutional disease were cured, if the syphilitic
disposition were completely eradicated, then the
patient would be able to contract a fresh indurated
chancre, with all the subsequent symptoms. If this
were the case — and he had observed it with great
care, his experience dating back forty years — it
proved that syphilis could be cured ; and if syphilis
could be eradicated, to ascertain whether a patient
was cured or not when all the symptoms had disap-
peared, there would be nothing else to do (though
he knew that could not be done) but to try inocula-
tion from an indurated chancre. If vaccination did not
take, they were sure the vaccine disposition continued;
if it did not continue, vaccination could take effect.
In regard to syphilis, the proof had not been carried
to this extent ; but he had been able to observe that
as long as the syphilitic influence continued, a pa-
tient could not contract an indurated chancre anew,
and that, consequently, if cured, a new infection
might take place. This was a great point gained
in science, and it proved what he had said, that
syphilis could be radically cured. Now, as to the
treatment of the disease. As he had told them,
Mr. Acton's ideas were completely his ideas, ex-
plaining his manner ot treatment and his practice.
He would first speak of the treatment of the first
stage — that was to say, the primary sore. As soon as
he had ascertained that there was a hardened chancre,
with a swelling of the glands — not inflammatory,
because the glands in this case never suppurated, —
he immediately instituted the mercurial treatment.
There was one point on which there was some dif-
ference of opinion : many believed that it was im-
possible to prevent the accession of the secondary
symptoms, the first manifestation of constitutional
disease ; many thought that no matter what treat-
ment was employed the sequelae would appear.
Well, he had ascertained that if the treatment were
soon begun and well carried through, the bursting
out of the first secondary symptoms, the roseola,
the swelling of the glands of the neck, &c, might
be prevented. If this were not frequently the case
it was because the treatment was resorted to too
late, when the disease had had time to take root,
and secondary symptoms were about to show them-
selves. In such cases it was not astonishing that
secondary symptoms should appear, and the treat-
ment ought not to be blamed; if the treatment
were steadily continued they soon disappeared.
But if the treatment were begun early, the observa-
The Medical Union.
35
tion of forty years gave him the assurance that
secondary symptoms would not appear. When
secondary symptoms had appeared, the best treat-
ment was, as Mr. Acton had said, mercury. If
they wished for a perfect cure, this treatment must
be continued. In general, it was not persisted in
long enough ; it was dropped as soon as the symp-
toms disappeared, or a short time after, and then it
was not astonishing to see them reappear. But if
the treatment were continued five or six months,
having regard at the same time to sustaining the
constitution in general, relapses would be found to
be infrequent. He observed very few cases of
relapse, and there would not be many when the
treatment was well kept up — when the patient had
patience enough, and the physician sufficient cour-
age. After six months of that treatment and no symp-
toms reappearing, then the treatment with iodine
must be begun, and continued for five or six months
more. When a patient went to him, he said, "You
will . have a year's treatment — do you consent to
that?" "Yes." "Very well; we will go on. If
not, good bye." There were cases in which syphi-
lis occurred in a healthy person — the only disease
was syphilis. Then treatment was very easy — :the
case was a simple one ; they had but one enemy to
fight — all went on regularly. But, unhappily, in
many instances syphilis was not alone; there was
something else — scrofula, skin disease, scurvy, low
constitution, poorness of the blood. They must
understand that such complications as these altered
the case ; the treatment did not act so powerfully
as it would do in the first case, as many of these
complications were aggravated by the treatment.
For instance, syphilis and scurvy might coexist —
and the characteristic of the latter was poorness of
the blood, while that of the former was a plastic con-
dition of the blood. Here, therefore, was a counteract-
ing influence to the treatment for syphilis. Now, one
thing must be known : Perhaps he was speaking
too long ? (No ; go on. ) Well, in many instances
syphilis became the secondary consideration, and
they must begin with the constitution of the patient,
as debility was the disease that required first treat-
ment. They must attack the strongest enemy first.
Syphilis was sometimes quiet, and stopped and
waited till they came to it. So, when they had im-
proved the constitution, they might commence with
the treatment, and they must begin by treating the
constitutional complication. The best treatment
was the proto-ioduret of mercury. The stomach
bore this well in general. Sometimes it gave rise
to a little diarrhoea, which was an easy thing to
moderate : but when the stomach was not tolerant
of the remedy, one capital treatment was that
which Mr. Acton had told them he had confidence
in — namely, rubbing-in. If this were not an un-
pleasant and disagreeable operation, certainly it
would be in general about the best ; he himself
should prefer it. In rubbing-in, the action of the
remedy was powerful and quick, and the stomach
was not at all troubled with it. If it were not so
disagreeable, and were a thing that could be done
without being noticed, he should give it the prefer-
ence. However, there were cases in which the
skin was otherwise affected, in which there was a
skin disease, and then friction could not be
used. In a case of complication of syphilis and
herpes, rubbing-in could not be resorted to. In
general, patients bore the iodide of potassium well,
and in large doses. For his own part, he frequently
employed forty, sixty, eighty, even a hundred grains
a day, and more. They must bear in mind that if
they gave too small doses to some patients they
would have no result ; it was a remedy that passed
through the body with great rapidity. He had had
great experience of it, and he had found that in
half an hour it had passed away in the urine. Io-
dide of potassium was a sort of broom of the blood.
So they saw that the methodical treatment was this :
mercury, iodide of potassium. But only one for
the first stage, and only the other for the later stage
of syphilis ? No, the rule was absolute that as long
as there were secondary symptoms well marked,
mercury must be given ; when there was a mixture
of secondary and tertiary symptoms, mercury and
iodide; for tertiary symptoms, iodide. To treat
some patients with iodide would not advance them
in any way. Why ? Because there was frequently
in the constitution, in the blood, something of the
second stage, something that required the mercurial
treatment. This might not show itself, but when
iodide of potassium ceased to do good, the disease
remaining stationary, let them go back to mercury
again, and they would have a splendid result where
they had thought there was no further possibility of
curing the patient. This was what Mr. Acton had
said, and he was completely and absolutely of Mr.
Acton's opinion. But there was another thing.
When syphilis had lasted for a long time, and had
had a great effect on the constitution, it in some
way disappeared, and left the patient with a com-
plication existing that was not existing before.
Sometimes a long course of treatment brought on
a new disease — wasting of the constitution, poor-
ness of blood. They must then stop all the specific
treatment, and, applying themselves to the principal
symptom, restore the constitution by preparations
of iron, bark, tonics, and proper food, so bringing
the patient back to the possibility of undergoing
anew a regular methodical treatment, either by
mercury or iodide, or a combination of these two
remedies. In former times, when a person was
thought to be syphilitic, physicians seemed unable
to entertain any other idea than that of syphilis,
and acted exclusively against a specific disease,
neglected everything else, and in that way they ex-
perienced all the bad effects and accidental symp-
toms which a bad administration of the symptoms
would produce. Mr. Acton had spoken of the use
of bromide of potassium. His views were exactly
the same as Mr. Acton's with respect to the use of
the remedies at different stages, the necessity of
having regard to the complications that might exist,
and of dropping the treatment for a while till the
constitution was restored. This was regular and
methodical, and his own manner of practice. But
now, was bromide of potassium an anti-syphilitic
remedy? He did not believe that it was. He
might be mistaken ; but he had experimented with
it in syphilitic symptoms, and without any apparent
result. But it was a splendid remedy in complica-
tions of syphilis. In some cases of symptoms re-
ferable to the nervous centres, bromide of potassium
was an adjunct, and came to the help of mercury
or the treatment by iodine. In some cases of brain
disease with syphilis, and of disease of the spine or
epilepsy, bromide of potassium did wonders. So
that they would see it was a remedy to be applied
in nervous complications that might occur, but they
36
The Medical UnioH.
must not depend on it as an anti-syphilitic remedy.
Now, there were symptoms following syphilis which
were not syphilitic, and these must not be treated
with mercury or iodide of potassium. For instance,
there might be necrosis. Well, they could not
bring a dead bone back to life, no matter what
quantity of mercury or iodide of potassium they
might give. A physician must know these things,
and he (M. Ricord) ought almost to apologize for
bringing them forward. It should be observed that
specific remedies did not always act specifically.
Certainly, there was no specific effect without a
specific cause, but specific causes did not always
act specifically. So there were some effects of syph-
ilis, such as disease of the bones, that would after-
wards act as a common irritant. In syphilis there
might be an ulcerated bone in the nose or mouth,
bringing on suppuration ; mercury or potassium
would not remove that, but let the diseased bone be
removed, and the patient was frequently cured.
They must take note of all these conditions — the
nature of syphilis, the manner in which it conducted
itself, its action on the constitution. Let them par-
ticularly take note that the general law of syphilis
was the same as the general law of small-pox, vac-
cine, and measles. If they were sure of this from
what he had said and from their own experience,
then they might be sure that syphilis could be
perfectly, radically cured. They could tell their
patients that, and give them courage and hope. If
the patient had courage to go through with the
treatment, and the physician had courage enough
to stick to it, the patient might be radically cured.
He thanked them for the reception they had given
him ; it reminded him a little of his hospital in
Paris.
A question was asked whether Dr. Ricord was a
believer in salivation.
Dr. Ricord replied — No, surely not. Salivation
was an accident following the treatment, and it
must be avoided as much as possible. There was
but one case in which he approved of salivation,
and that was in disease of the eye — iritis. When
this occurred, and salivation was brought on, the
inflammation of the iris subsided.
Dr. Gross asked whether the soft chancre was
capable of contaminating the constitution.
Dr. Ricord said his opinion was that a soft chan-
cre, when accurately diagnosed, never gave rise to
constitutional disease. This was a law as absolute
as possible. But they must be careful, or errors of
diagnosis might be made. It was not always easy
to establish the difference between soft and hard
chancre, but when the diagnosis was certain, they
might be sure they would not have any constitution-
al disease after the soft chancre. On the contrary,
even as long as six months after hard chancre, sec-
ondary symptoms would appear. This was one of
the most clearly established facts in practice. But
the hardness of the chancre was not always well
marked (Men formulee); it might be very super-
ficial in those varieties that were attended with
excoriation. When there was a something like
parchment at the base, a chancre was very easily
taken to be soft, but was not so ; and he had had
cases sent to him as instances of soft chancre which
had been followed by secondary symptoms, but
which were well characterized by the parchment-
like base. However, there was a symptom of more
value than the parchment base, a symptom that
was one of the most important witnesses to consti-
tutional affection, and that was the non-inflamma-
tion of the glands — they were cold and dull. In
general several of them became enlarged; it was
very seldom that only one was found to swell after
hardened chancre ; and not only were the glands
swollen, but the enlargement frequently occurred on
both sides, in both groins. The enlargement of
the glands was of much value as a characteristic of
hardened chancre. The enlarged glands appeared
very early, even during the first fortnight of the ex-
istence of the sore. With the soft chancre the
glands did not always swell ; in a great many cases
there was no swelling. They would never find a
real hard chancre without swelling of the glands ;
and they would also find many cases of soft chancre
with swelling, these cases depending upon surgeons
confounding the hard chancre with thickening de-
pendent upon inflammatory infiltration of the tissue
immediately around the sore. But if the glands
should swell after soft chancre, it was probable that
suppuration would come on. With hard chancre
there was no inflammation and no suppuration.
The older writers directed their efforts to cause an
indurated sore to suppurate, in the belief arising
from the practical observation that when a bubo
suppurated there was no constitutional disease, and
therefore they were under the belief that the poison
was thrown out of the body. In their quaint way
of putting the fact, "they did not like to shut up
the wolf within the fold." But they could not bring
on specific suppuration in the case of indurated
glands ; it was impossible. He had tried all means
of doing it, and could not succeed in the cases of specific
suppuration. In the instance of soft chancre what
had they to do— await the occurrence of suppura-
tion, which might either be attended by simply
inflammatory or specific bubo? With the soft
chancre the inflammatory bubo appeared sometimes
two, three, or four weeks after the occurrence of
the chancre, and it had the characteristic pus of the
soft chancre. There was such a difference between
hard and soft chancre that it was difficult to make a
mistake. When a patient consulted him (M.
Ricord) suffering from soft chancre he said to him,
"Be quiet; you may have a bubo ; that will sup-
purate, but your constitution will be unaffected;
you will not be liable to secondary symptoms."
With a hard chancre he could predict indurated
glands, attended by constitutional symptoms, with-
in six months, provided proper treatment were not
followed. He would add, that when it was decided
that the case was one of hard chancre or soft
chancre, the treatment was very simple. When
there was a doubt as to the nature of the chancre,
he waited till some characteristic symptom arose.
But there were cases in which the existence of a soft
chancre did not prevent a patient from contracting
a hard chancre. The patient might have the two
species at the same time, contracted from different
sources. The two species, hard and soft chancres,
do not depend upon the difference in the ground,
but on a difference in the seed (contagium). So
that the new comer who had relations with a woman
suffering from the two species could take his choice.
If the patient, had a true indurated chancre and
well diagnosed secondary symptoms, he might
catch the soft chancre as often as he pleased, and it
would be unattended with specific constitutional dis-
turbance.
The Medical Union.
11
The Medical Union
A MONTHLY JOURNAL
Of Medicine, Surgery, and the Collateral Sciences.
Editors :
EGBERT GUERNSEY, M.D. CHARLES E. BLUMENTHAL, M.D.LL.D.
JOHN C. MINOR, M.D. ALBERT E. SUMNER, M.D.
Published on the First of each Month, by
C. T. HURLBURT, 898 Broadway, New York.
NEW YORK, FEBRUARY, 1873.
MEDICAL UNION.
The Hon. J. H. Baker, U. S. Commissioner of
Pensions, has recently taken a position in favor of
Medical Union which will, if we mistake not, lead
to important results. In his report to the Presi-
dent, on the condition of his department, he says :
" In selecting persons to act as examining surgeons
it is believed that greater than ordinary care has
been used to secure men of broad views, liberal ed-
ucation and thorough professional acquirements,
without regard to theories or schools;" and lest
there should be any doubt as to his meaning, mem-
bers of the different schools of practice have re-
ceived appointments from his office. Not content
with this, however, he has organized the Brooklyn
Board with two of the old school and one 0/ the new,
leaving them to settle a problem that has, of late,
attracted a great deal of attention in political and
medical circles — namely, "Is it possible for the
members of two schools of practice to work intelli-
gently and harmoniously together for the public
good ? "
Now let us look at the history of this case. On
the 20th of June, 1870, Dr. H. Van Aerman, Com-
missioner of Pensions, wrote to Dr. Spooner of
this State, "It is deemed necessary that all exam-
ining surgeons for the bureau should belong to one
school and adopt one theory of medicine. As you
do not belong to the school of medicine recognized
by the bureau, you are requested to withdraw your
name from the list of examining surgeons, and ac-
cept my thanks for services already rendered."
This letter was presented to several county socie-
ties, and to the State Homoeopathic Medical So-
ciety, by whom resolutions were passed protest-
ing against the action of the Commissioner, and
asking for his removal. He was removed. Gen.
J. H. Baker was appointed his successor, and
all who had been removed by Van Aerman were
reinstated. Shortly after Gen. Baker's appoint-
ment, a letter from the Department was sent to Dr.
Leighton, the Secretary of the Brooklyn Board of
Pensions, making inquiries relative to the profes-
sional standing of Dr. Albert Wright of that city.
An answer was returned, "Ashe is a Homoeopath,
I cannot say anything of him professionally." Now,
the printed instructions to examining surgeons
from the bureau contain this clause, "In inquir-
ing as to the professional standing of such (medi-
cal) witnesses, it is not intended to ask their stand-
ing in the school of medicine to which the surgeon
certifying is attached, but their standing in the
school to which they themselves belong. Are they
recognized as reputable practitioners in their re-
spective communities and by their confreres of the
same school of medicine ? "
It was ascertained by the Department that Dr.
Wright was an old established physician of excellent
character and good repute ; and that Dr. Leighton
lived near him, and could have answered the ques-
tion correctly if he desired to do so, consequently
Dr. L. was removed. A petition was then circulat-
ed among the members of his school, and very gen-
erally signed, asking that he be reinstated. He was
reinstated, only to find himself associated with a
Homoeopath on the Board. His appointment
placed him in a very peculiar position. He had
asked for it, his friend had visited Washington to
obtain it. Hundreds of his own school had petition-
ed for it, and when the coveted prize was obtained
he could not accept it without endangering his
position as a member of the Kings County Medical
Society, the New York State Medical Society, and
the American Medical Association, these societies
having adopted the same code of professional ethics.
That code (article 4, section 1) acknowledges that
"a regular medical education furnishes the only pre-
sumptive evidence of professional abilities and ac-
quirements, and ought to be the only acknowledged
right of an individual to the exercise and honor of
his profession," and then asserts that "no one can
be considered as a regular practitioner or a fit asso-
ciate in consultation, whose practice is based on an
exclusive dogma." For such as do consult with
gentlemen "not recognized by this Association,"
three methods of discipline are provided by the Kings
County Medical Society : 1st, Admonition ; 2d,
Suspension ; 3d, Expulsion. Yet, on a reference to
this Society it was decided to ignore these rules and
quietly accept the situation, unpleasant as it must
have been to them. What the American Medical
Society will do about it we can only surmise ; but
as they succeeded so admirably in disciplining their
members in the Massachusetts State Society, they
may decide to try it again here. It is an excellent
thing for "brethren to dwell together in unity."
Gentlemen of the old school, why will you cling to
the traditions of the past ? Why pretend that you
believe in medical any more than in ecclesiastical
infallibility? Why cling to your discipline when
you know that every attempt to enforce it brings
38
The Medical Union.
ridicule and disgrace and defeat ? Why denounce
every other form of practice when every medical
work published by the members of your school teems
with laments over your inability to control disease ?
Do you not know that the establishment of a na-
tional religion would be fatal to this government,
and can you not see that a national system of medi-
cine is equally impossible? Did not your school
first banish Galen from Rome, and then adopt him
as your leader? Did it not ridicule Michael Ser-
vetus for proclaiming that the blood flowed through
the veins ? Did it not persecute Harvey when he
announced his theory of the circulation, and de-
nounce Jenner for the introduction of vaccination ?
The time for such nonsense has passed, and this, of
all countries on the globe, offers the poorest field
for its exhibition. The people are intelligent and
thoughtful, and detest anything like bigotry ; and,
whenever an attempt is made to crush out the life
of any sect, race or school, hosts of friends are at-
tracted to it at once. The attempt to extend sla-
very resulted in placing the colored man in the
United States Senate. The attempt to crush our
school will result in its being introduced into the
army and navy; and, when that is effected, the
barriers between the two schools fall to the ground.
Then we have a " school of brains," in which he
wins who accomplishes the most good, and where
all are free to practice as they like. This is all we
ask, and this you will eventually have to concede.
THE WORLD MOVES.
At a recent meeting of the Oneida Co. Medical
Society (allopathic), Dr. Hutchinson offered the
following resolution: "That our delegates to and
permanent members of the State Medical Society
be requested to urge that body to amend section
four, paragraph one, of the Code of Medical Ethics
so as to allow members of county medical societies
to meet in consultation, all practitioners who are
recognized by the laws of this State, whenever called
upon by them or their patients." After a somewhat
lengthy discussion, it was thought best to leave the
subject to the action of the State Society. Dr.
Hunt offered a resolution "that the Code of Ethics
be so amended as to be more in harmony with the
spirit of our republican institutions," but the reso-
lution was tabled. What has the spirit of repub-
lican institutions to do with a Code of Ethics,
which would have been a disgrace to the darkest
days of the dark ages ? Rip Van Winkle is indeed
awakening from his long sleep, and the sunlight is
somewhat blinding.
The Wisconsin State authorities are about to
change the mode of treatment hitherto adopted in
the State Asylum for the Insane, by the appoint-
ment of a homoeopathic superintendent.
In the appointment of Pension Surgeons, the Gov-
ernment, in a printed form of instructions to its
medical officers, refuses to discriminate in favor of
the adherents of either school of medicine.
The Surgeon-General of the army has recently
announced a desire to receive copies of all homoeo-
pathic publications, for preservation in the library of
his department at Washington.
It really seems as if the world is moving after all,
and one by one the strongholds of bigotry and in-
tolerance are crumbling away before the advance-
ments of science. These little signs of the times
point clearly to the no distant day when all educa-
ted medical men may fully unite, not only in their
associations for the advancement of medical science,
but also in daily practice for the relief of human
suffering.
We can afford to smile at the narrow-minded big-
otry of some of the allopathic medical colleges and
societies who still crack the whip to keep up their
spirits, while they mourn for those good old days
when Galileo was placed upon the scaffold by the
learned men of his day to renounce the grievous
error and damnable heresy of the revolution of the
earth. The spirit of the old inquisitors, however,
still lives in their hearts, but the power has passed
away.
Dr. Flint, the Secretary of Bellevue Hospital
Medical College, in reply to the question of an old
graduate of that college, but now a homoeopath,
"Can one of my students be admitted as a member
of your school on the same terms as others?" says :
"He can attend the lectures, but in no case will the
certificate of a homoeopath be received as his pre-
ceptor." The impudence of this college is really
amusing. Oh yes, we will take your money, they
say, but you shall not graduate if you bring us a
certificate of study from a homoeopath, no matter
though he may himself have been a graduate of this
institution. If you expect to receive our diploma,
there must be no stain of this damnable heresy on
your garments. Those who have once seen, and
enjoyed the instructions of the dignified and courtly
savants who form the Faculty of this college, can
only appreciate the terrible nature of the rebuke.
This institution enjoys advantages in having its
teachers on the medical staff of the hospital, so
that into its clinique can be brought an immense
amount of interesting material. In fact the ring is
in power just now, and can, if it chooses, insist that
the only gateway for the student to an appointment
in the hospitals under its care, must be through
some "regular" medical college. But how long
will the people who pay the taxes for the support of
these institutions submit to the insolence of these
men? How long will the State permit its chartered
institutions to be shut out from their just rights ?
The Medical Union.
39
Political rings have been broken in pieces when they
have grown too corrupt for public endurance ; what
is to prevent this even more corrupt sectarian medi-
cal ring being swept away, when the public shall at
last have grown tired of its arrogance and incom-
petency? _____
A SUBSTITUTE FOR THE PRAYER TEST.
OUR friends, the parsons, are very justly indignant
that such a proposition as that supported by Professor
Tyndall should be seriously considered. The prop-
osition to test the efficacy of prayer arises from a
desire on the part of some scientists to submit to
actual experiment a doctrine held by many as part
of their religious belief. If "the prayer of faith shall
save the sick," why not give an opportunity for de-
monstrating the actual value of prayer, as compared
with ordinary methods of saving the sick ? Why not
devote the patients in one or two wards of some pub-
lic hospitals, as objects for the special prayers of
those who believe in the efficacy of prayer, while in
all other respects the patients are treated as usual so
far as medical attendance is concerned ? At the
end of a given time the hospital records will show
whether there has been any notable decrease in the
mortality of "the prayer wards " — whether those who
have been prayed over have fared any better than
those who were dependent on medicine alone —
whether, in fact, there is any power in prayer to
"save the sick" that can be demonstrated and de-
pended upon. If there is such virtue in prayer as
we are led to believe by our religious tenets, then
prayer should form an important element in the
treatment of the sick. If, on the other hand, our
belief in the efficacy of prayer is proved to be an
erroneous belief, then we must acknowledge the
# very foundation of our religious faith to be sorely
shaken.
Such, in brief, is the tenor of the proposition to test
the efficacy of prayer. We do not propose to enter
into the controversy, for we are satisfied that the
parsons, with whom we heartily agree, are perfectly
able to dispose of the proposition without our help.
But while we condemn the proposed test of prayer
as an impracticable and foolish proceeding of more
than doubtful propriety, we propose in place of it
another test that is neither impracticable, absurd,
nor of doubtful propriety.
We propose that Homoeopathy be submitted to a
test as searching and conclusive as even the most
pronounced enemies of Homoeopathy could desire.
We ask the Commissioners of Charities and Correc-
tion to set aside the half of any one of our public hos-
pitals for a test of the efficacy of Homoeopathy. Let
one-half of Bellevue hospital, for instance, be under
the control of homoeopathic physicians and surgeons,
and the other half remain under its present manage-
ment. Let there be no discrimination as to the pa-
tients admitted — every other patient going to the
homoeopathic wards, or, the patients being number-
ed as they are admitted, let the even numbers be
under homoeopathic, and the odd numbers under
allopathic treatment; so that perfect fairness may
be insured in the comparative gravity of cases under
treatment. Let perfect impartiality be shown to
both sides. Every part of the hospital should be
at all times open to the inspection of the proper
authorities, and Committees of Inspection should
make frequent visits, unannounced, to both sides.
At the end of the year, let the results of the two
methods of treatment be presented in separate
and independent reports to the Commissioners of
Charities and Correction, and through them to the
public.
We claim that such a test as this will show that
under homoeopathic treatment, the mortality will be
at least 25 per cent, less than under the present treat-
ment ; and we also claim that the expense of
homoeopathic treatment will be at least 25 per cent,
less than the allopathic. Claiming, then, that
homoeopathic treatment can save 25 per cent, more
lives than allopathic treatment, and that it will not
only be more efficient, but less expensive by 25 per
cent, than the present treatment, we ask the ques-
tion, is it worth while to test this thing?
We wish to make this proposition a perfectly plain
and practical one, and we know of no better way
than to treat it as a matter of business. If we should
go to some contractor and show him how he could
carry out a contract with less money, and at the
same time perform better work than could be ac-
complished by the ordinary methods, he would
think it worth his while to test the thing. We have
just such a proposition to make to every property
holder in this city, for each one is a partner to a
contract which binds him to take care of the sick
poor. He is taxed for the support of the public
hospitals, and it is for his interest to have them
managed economically. As it costs more to have a
patient die than to have him recover, the most suc-
cessful treatment will also be the most economical.
It has been estimated that New York pays out
every year as much money for her hospitals as
would provide all the patients with rooms and board
at the Fifth Avenue hotel, and leave a balance for
opera tickets for the convalescents. When we speak,
then, of saving 25 per cent, of the expense, we allow
a wide margin. We claim, however, that homoe-
opathic treatment is from its nature a cheaper treat-
ment than any other, and in proof that our claim is
well founded, we refer to the annual report of the
Comptroller of the State of New York, where it will
be found that the average cost per patient in the
various hospitals and dispensaries of the city is about
40
The Medical Union.
50 per cent, in favor of Homoeopathy on the ground
of economy alone. Our claim for Homoeopathy,
however, is mainly based on its efficiency. It is the
saving of 25 per cent, more lives that is to be the
test, and the saving of 25 per cent, in the expense of
treatment is a secondary matter.
Whenever the claims of Homoeopathy are op-
posed by the old school, the basis of opposition is
invariably narrowed down to one statement, viz:
that statistics are unreliable. It is a strange argu-
ment to use against Homoeopathy when, in all
other things, statistics are regarded as the strong-
est possible evidence. The moral turpitude of
figures which lie so persistently on one side of the
question is appalling to every right-minded stati-
cian ; but when it is considered that these wicked
figures give the same incorrigible results, even
when the facts are collated by the opponents of
Homoeopathy, it is certain either that the character
of statistics is forever lost, or that all that has been
claimed for Homoeopathy is true.
An inspection of a few of these figures will repay
perusal. In the annual report of the Inspectors of
the Michigan State Prisons for 1862, the results of
the different systems for three years — 1860, 1861,
1862 — are given, as follows:
A llopathic. Homoeopathic.
Prisoners, . . . 435 544
Deaths, 39 2Q
Days' labor lost, . . 23,000 10,000
Cost of medicines, . $1,678 $500
During the war, two military hospitals in St.
Louis, Mo., were placed respectively, the one un-
der the care of Dr. Franklin, a homoeopath, the
other under that of Dr. Paddock, an allopath. The
following is the official report for six months, ending
September 30th, 1864 :
Homoeopathic Hospital.
Cases.
Cured.
Dud.
Typhoid fever,
39
35
2
Pneumonia, .
13
J3
O
Diarrhoea, .
95
92
3
Dysentery, .
32
27
5
All other diseases,
654
646
3
Totals, . . . 833 813 13
The balance remaining under treatment.
Allopathic Hospital.
Cases.
Cured.
Died.
Typhoid fever, . -
IO
2
7
Pneumonia, .
23
IO
12
Diarrhoea, .
I06
71
23
Dysentery, .
30
7
21
All other diseases,
821
641
57
120
Totals, . . . 990 731
The balance remaining under treatment.
A recent inquiry into the register of deaths kept
by the Metropolitan Board of Health of this city,
shows that during the years 1870 and 1871, there
were, in private practice, the following comparative
results between the old and the new school :
" Nine hundred and eighty-four (984) Allopathic
physicians lost 30,395 cases ; 156 Homoeopathic phy-
sicians lost 2,530 cases, averaging 30. 89 deaths to
every Allopath, and 16.22 deaths to every Homoeo-
path practising in New York City during the past
two years I In other words, the mortality under
Homoeopathic treatment is, proportionately, only 53
Per cent, of the mortality under Allopathic treat-
merit, where the physicians of the two schools have
been practising side by side." The worst of these
figures is that the more they are investigated the
more incorrigible do they become. Collected and
arranged by an allopathic board they will persist in
giving their evidence in favor of Homoeopathy. As
long ago as 1836, the Austrian Protomedicus re-
ported to the Government that in the Vienna
Homoeopathic Hospital two-thirds of the cholera
patients recovered, while in the allopathic hospitals
two-thirds of them died ; and on this report was
based the decree of the Emperor, still in force, legal-
izing the practice of Homoeopathy in Austria. From
that time, and even earlier, to this, these absurd
statistics have been accumulating, and these wicked
figures have been telling the same old story. The
practice of Homoeopathy seems to be gaining ground
among the people. It appears to have taken a
strange hold on the wealthier and more intelligent
classes, that can only be explained by the fact that
some people believe the figures. It is time that the
fraud should be exposed, if it be a fraud, and the
question of the efficacy of Homoeopathy be publicly
tested. For our part we promise our best efforts to
bring the question to an issue.
THE DEATH RATE IN NEW YORK FOR 1872.
From the report of Dr. Charles Russel, Register
of Records, Health Department, we learn that the
total number of deaths in New York City the past
year was 32,647, giving an annual death rate of
32.86 in each 1,000 inhabitants, the population
being estimated at 1,000,000, and that of these
deaths about 50 per cent, were of children less than
five years of age. The mortality of the year was
nearly 5,500 over that of any previous year.
" The peculiar influences, meteorological or other-
wise, which contributed to so large a mortality,
are not altogether apparent, as the rise in weekly
mortality began to be noticeable in the very begin-
ning of the year and continued to the end. Such
causes were certainly not confined to this city, as
every large Eastern city from which we have yet
received returns participated to even a greater ex-
tent in the same trouble. During 1872, as com-
The Medical (/mofi.
41
pared with 1871, the increase in Boston was 34 per
cent. ; in Providence and Philadelphia, 28 per cent. ;
in Brooklyn, 23 per cent. ; and in New York only
21 per cent. That of Cincinnati was normal — about
6 per cent. A large territory along the Atlantic
was thus overspread by the same disturbing ele-
ments. The summer's heat was certainly remark-
able, and its humidity high, to which circumstances
we may attribute much of the mortality of the last
season and early autumn ; but the meteorological
phenomena of the rest of the year offered no
features extraordinary enough to account for the
unwonted death rate.
" The zymotic class of affections produced 8,364
deaths in 1871 — 31 per cent, of the total — and
11,922 in 1872 — 37 per cent, of the total; an excess
of 3,558 deaths, or of 69 weekly. Every important
disease of the miasmatic group shared in this in-
crease save relapsing fever, whose mortality in both
years was so trifling as to exclude it from the list
which we now present :
Deaths from 1871. 1872.
Small-pox 805 929
Measles 409 463
Scarlatina 791 990
Diphtheria 238 446
Croup 466 675
Whooping-cough 465 565
Typhus fever 65 86
Typhoid fever 239 364
Typho-malarial fever 12 22
Intermittent fever no in
Remittent fever 165 193
Cerebro-spinal fever 48 782
Puerperal fever 80 107
Diarrhceal diseases 3*653 5, 197 "
Cerebro-spinal fever became epidemic early in the
year, and destroyed 782 lives. The same disease
was credited with 32 deaths in 1867, 34 in 1868,
42 in 1869, 32 in 1870, and 48 in 1871. Of the 929
cases of small-pox, 50 per cent, of the deaths were
in the Eleventh and Seventeenth Wards. As these
wards contain but 1 7 per cent, of the entire popula-
tion, the fact affords a very suggestive commentary
on the remarks made on another page of the fear-
ful overcrowding and lack of ventilation in the tene-
ment houses in certain localities. The fact also,
that in this nineteenth century, in a city washed on
all sides by tide water, easily drained, and which
might be made the most healthy in the world, nearly
one-half of all the deaths are of children under five
years of age, should not be forgotten. And all the
time our taxes are increasing at a fearful rate.
Money is poured out like water, money which, if
properly spent, would make our city the most beau-
tiful, the most healthy in the world. It is true these
fifty per cent, of deaths are only children,
" But the child's sob in the silence curses deeper
Than the strong man in his wrath."
THE POST-MORTEM OF NAPOLEON III.
In another column will be found the official report
of the doctors who made the post-mortem examina-
tion of Napoleon III. We must confess that there
is very little to be gained from its perusal, but we
advise our readers to study it, and perhaps their
opinions will differ somewhat from ours in the case,
and perhaps not. After a careful analysis of the
paper in question, we are compelled to believe that
this report is intended as an apology to the public,
rather than as an explanation to the profession ; but
whether as an apology or as an example of patho-
logical research, it is alike unsatisfactory, incom-
plete, and unscientific. We are told that the patient
died "from failure of the circulation." It would
have been expressed in more popular and equally
satisfactory terms if the patient had been reported
as "dead from want of breath." It would have
been more honest if the physicians had acknowl-
edged, in plain terms, that they did not know the
cause of death, and were unable to find it out. But
instead of this they have committed themselves to
an opinion which appears to have one fact as a basis,
and two hypotheses as a superstructure. "Death
took place," says the report, "by failure of the circu-
lation, and was attributed to the general constitu-
tional state of the patient. The disease of the kid-
neys— of which this state was the expression — was of
such a nature, and so advanced, that it would in any
case have shortly determined a fatal result." Dis-
ease of the kidney is the fact ; it is assumed that
this disease produced a peculiar constitutional state,
and that this constitutional state produced failure of
the circulation and death. Dr. William Gull pre-
fers to consider a disease of the bladder as the prior
lesion and accepts everything else in the report.
But it will follow logically, and pathologically, that
if Dr. Gull is right, then the others are wrong. No
experienced physician will accept the statement that
sudden death can be dependent upon cystitis of the
"sub-acute" variety, nor is the evidence of the con-
dition of the kidneys sufficient to warrant the asser-
tion that they were the cause of death. Hundreds of
men are attending to their ordinary avocations to-
day, whose kidneys are in a much worse pathologi-
cal condition than those which are reported to be the
cause of Napoleon's death. This was not a case of
Bright's disease, nor indeed is there any attempt on
the part of the doctors to class it among the varieties
of Nephritis, where it properly belongs. No mention
is made of the rheumatic or gouty diathesis of the
patient which obliged him to resort so often to the
waters of Vichy. We have not been informed what
internal remedies were used, how much chloroform
or ether was administered, or what the thermometer
revealed as to his vital condition. We are only told
that "there was no disease of the heart nor of any
42
The Medical Union.
other organ, excepting of the kidneys," and are left
to infer that there was either no cystitis, or that the
bladder is not an organ.
We are willing to admit that the very best medi-
cal and surgical skill was employed in the case, but
when we consider that the case was one in which
the treatment from beginning to end must bear the
criticism of the whole world, and that these doctors
were the representatives before the world of the
highest and latest development of medical science,
we have a right to expect, for the honor of the pro-
fession, that a full and complete explanation of the
case, based on the post-mortem examination, should
terminate the labors of the medical attendants, and
in this expectation it is needless to say we are disap-
pointed.
As to the operation of lithotrity as performed in
the case by Sir Henry Thompson, we are not pre-
pared to give an opinion with the brief information
at hand. We can hardly credit the report that
such an accomplished and experienced surgeon
could have committed the errors of carelessness,
want of delicacy in manipulation and undue haste,
as alleged by Nelaton. Our province is to examine
facts rather than rumors, and it is more than suffic-
ient for us to know that the post-mortem examin-
ation was a piece of bungling, and that so many
eminent men signed their names to it.
Che JFle&ical Union iClintc.
Facial Paralysis, treated with Electricity, Nux-
Vomica and Hyosciamus. — In October last, a gen-
tleman, of active business habits, came to me with
the left side of his face and tongue paralyzed to
such an extent that he was unable to retain any-
thing in his mouth, or even to swallow, except with
his head thrown well back. The treatment was
nux-vomica and hyosciamus, with the daily appli-
cation of electricity. In seventeen days, every un-
pleasant symptom had passed away, and he was
again able to attend to business.
George Beakley, M. D.
Veratrum Viride in Puerperal Peritonitis. — Mrs.
R., age 33, aborted about the third month. Had
considerable hemorrhage daily for three weeks,
when she had a chill, followed by fever, with severe
pain in the uterine region, and sharp darting pains
throughout the abdomen. The fever increased in
intensity, pulse being 140, heat of skin 1030, vio-
lent headache, with slight delirium on the third day,
great ten derness over the whole abdomen, and con-
siderable tympanitis. The discharge from the uterus
became offensive. About the fifth day, vomiting
began, the patient complained of agonizing pain in
the back of the head and down the spine ; also said
she could not see. The physician in attendance
becoming alarmed, asked me to see the case. I pre-
scribed veratrum viride gtts. xx, water iv. oz., two
tea-spoonfuls every hour; compresses, wrung out
in cold water, to be applied to the abdomen and
changed frequently, and ordered the attendant to
rub the back of the neck and down the spine with
the hand dipped in cold water. Saw the patient
the next day; all the symptoms modified; treat-
ment continued. In ten days the patient was well
and able to ride out. No other remedies were used,
except permanganate of potash injections, to cleanse
the vagina and destroy the odor.
G. C. Brown, M. D.
Pleuro- Pneumonia. — Mrs. C. H., 28 years old,
scrofulous, suffered periodically from a troublesome
cough. The 20th of December, 1872, she took a
long walk, thoroughly soaked her shoes and stock-
ings, and neglected to change the latter on her return
home. During the night she had a high fever with
chills creeping down her back, and internal chilli-
ness.
I saw her in the morning, December 21st; she
complained of severe pains in the forehead, con-
stant restlessness, inability to lie on either side,
frequent dry cough, and when she was able to
raise sputa, they were rusty-colored and streaked
with blood. On examination, found the tempera-
ture of the body 106.7, face red and eyes glistening.
Percussion over the 3d and 4th ribs dull ; below,
deep resonance; auscultation showed rattle of mu-
cous from beneath the second to the fourth rib ; and
below a rasping rattle. Pulse 140.
The first remedy given was Aconite 30th ; contin-
ued through the day and night. The next day, most
of the febrile symptoms having subsided, and her
restlessness disappeared, she having slept comfort-
ably through the night, Asclepias tub. was adminis-
tered, one drop every hour. The third day the
sputa changed from rust-colored and blood-streaked
to a pure white ; was able to lie on the right side and
coughed without pain or exertion ; no rattle, mucous
or otherwise. Appetite returned; pulse 90; percus-
sion normal. Asclepias continued.
The fourth day, she was very comfortable. Slept
eight hours without coughing. Coughed but little
now ; sat up and ate a hearty meal. Left two drops
Sulphur 30th. Has had no relapse or cough since,
up to the present time.
C. E. Blumenthal, M. D.
Mercurial Necrosis of the Lower Jaw — The Bone
Thrown Out by Nature — Reproduction of the Jaw.
— Lillian L., ten years old, a resident of Green-
point, was brought to my surgical clinic Oct. 22d,
1870, with the following history: When she was
two months old she had an attack of inflammation
of the lungs, and ever since she has been subject to
such attacks, especially in the winter time. In Feb-
ruary, 1868, she was attacked in the usual manner,
and was treated at a dispensary (Allopathic) in this
city. She was salivated. As her mother described
it: "Her mouth became sore; the spit dribbled
away all the time and was stringy ; her teeth loos-
ened, and her breath was very offensive." She suf-
fered from "toothache" in the vicinity of the first
molar of the left side. This "toothache" spread
all over the jaw, and the whole jaw became swol-
len. Some pus oozed out from the alveolar ridge,
but this discharge was soon diverted in another di-
rection. An abscess formed under the chin, and
then another, and so on until a chain of abscesses
gathered under the jaw. From these abscesses pus
The Medical Union.
43
was at first discharged, and then occasional pieces
of bone. The swelling about the jaw was very
much reduced after the breaking of the abscesses.
In 1869 these abscesses had become fistulous open-
ings, leading down to dead bone. In 1870 the fistu-
las became united in one cavity, and in July, 1870,
the entire bone, including the condyles, came out
spontaneously. The parts immediately closed, and
when she was brought to me there was only the scar
to show how extensive the opening had been. Oc-
tober 22d, 1870, I presented this case before the
class in surgery, a little rosy-cheeked girl with a
scar under her chin, and not one of the students
was able to tell, from any external examination,
what had occurred to the patient. And when I af-
terwards produced her old jaw-bone, it required tan-
gible evidence to convince them of the realities of
the case. The patient, at this date (October 1870),
three months after the spontaneous removal of the
dead bone, presented the following characteristics :
The new bone was of the same size as the original
bone ; there was no retraction of the chin (as in the
case reported in the last number of the Union,
where I removed the lower jaw of an adult by op-
eration), and all the movements of the jaw were
free and natural. The new jaw was in fact a fac
simile of the old one, except that it contained no
teeth. This child' came of a tuberculous family ;
she had a lateral curvature of the spine, and was
undoubtedly a scrofulous subject, although her face
presented a perfect picture of health. She was
subject to nightly attacks of pain, and complained
of ua tired feeling" during the day. I placed her
upon Phosphorus 1 and cod liver oil. My last report
of the case was : "Dec. 3d, 1870, she is rapidly
gaining in strength; has a good appetite, and is
able to go to school half a day."
J. C. Minor, M. D.
Epidemic Ophthalmia — Egyptian Ophthalmia. —
In the early summer of 1865, it was my privilege, as
well as pleasure, to have the charge of the ophthal-
mic department of St. Peter's Hospital in Brook-
lyn. This department had been rendered a neces-
sity, by the appearance of an epidemic ophthalmia,
which had suddenly attacked a great number of
children attached to the school of St. Peter's
church. Its spread was so rapid that a separate
building was found essential to the proper care of
the children. When I took charge there were
fifty-two little patients, and most of the cases were
in the advanced stages of the disease. The room
in which I found my patients was lighted by six
large uncurtained windows, and they were seated
on benches about the room industriously bathing
their eyes from bowls, which they held in their
hands, containing a weak solution of nitrate of sil-
ver. I found that the disease was introduced into
the institution by one of the children, who had
contracted it outside, and who communicated it to
the others by means, probably, of the towels placed
for the general use of the children. As soon as
possible I divided them into three classes. The
first class was made up from patients in the first or
inflammatory stage. The second class contained the
patients suffering from the full violence of the
disease, and the third class contained the con-
valescents. These classes were placed in separate
apartments, and the light excluded. I found the
earliest symptoms to be that of intense itching,
accompanied by dryness of the conjunctiva, which
lasted but a few hours. Then the Meibomian
secretion seemed increased, but changed from a
thin acid secretion to a thick, muco-purulent one.
The vessels of the conjunctiva became engorged,
and the patient complained of a feeling as if sand
was thrown into the eyes. This was followed by
cedematous swelling and eversion of the lids
(ectropium).
In certain cases the whole of the cornea was
involved, and in five cases rupture of the cornea
was the result. Of these cases it is only fair to
say that in each case the disease had progressed
some time before I took charge of the institution,
and that they were the only cases out of the entire
number (138) where the sight was destroyed.
Treatment. — In referring to my note-book I find
that the Extract of Hamamelis, known as Pond's
Extract, played a most important part in the treat-
ment of all of the patients. In many cases it was
sufficient for a cure, and in all cases it was of
inestimable value. This extract was diluted one
half with water, and a cloth wet with it bound
over the eyes. It was invariably the first remedy
ordered, and the last one to be discontinued. The
other principal remedies used were, Belladonna,
Hepar Sulph., Rhus-Tox., Mercurius Sol., Silicia,
and the Iodides of Sulphur, Arsenic and Iron.
The patients were allowed a very liberal diet of
meat, vegetables and fruit.
A. E. Sumner, M. D.
The Treatment of Paronychia Palmaris. — An in-
flammation of the fasciae of the palm of the hand
is one of the most painful affections to which
the human body can be subjected, and one which
formerly gave me less satisfaction — and my patient,
too — than almost any other inflammation which I
have had to treat. Such cases are rarely presented
to the physician for treatment until after inflamma-
tion is fully established, and I have never yet found
the homoeopathic remedy that would cut it short,
or in any way prevent it from running a full course
of inflammation, suppuration and agony. Sil.
Mer., Rhus, Hep. Sul., Aeon., had no such effect,
lancing and poultices, the same. Being disgusted
with the result of my efforts in constitutional treat-
ment, I determined that my future cases should be
treated differently and locally.
My first case, after I arrived at this conclusion,
was a gentleman who called at my office for advice
about his hand, which, he said, was paining him
terribly. The hand was very much swollen, the
inflammation and pain extending up his arm to the
axilla.
I thought I would try Hill's treatment of hot salt
bath and salt and turpentine, which I instructed
him how to use. The next morning he sent for
me and said he could not stand the turpentine and
salt, as it made the pain ten times worse.
I found the hand very much swollen, the skin
hot and dry, pain intense, extending up the arm.
There was one point which indicated suppuration,
which I lanced. I then told him to get a pitcher
in which he could put his hand ; I then filled it
with water above the wrist, and poured in about an
ounce of Hamamelis, telling him to keep his hand
in it as long as he could, and, when tired, to wrap
it up in a cloth wet with the solution. I also gave
him Aconite to take once an hour.
44
The Medical Union.
The next morning I called and found him read-
ing a newspaper. He said that in less than an hour
the pain entirely left his hand and arm, and he
went to sleep, which he had not done for a week
previous. Of course I was delighted, and he too,
at the prompt action of the Hamamelis.
The swelling of the arm had even then entirely
subsided, and the size of the hand was very sensi-
bly diminished. There was a discharge of pus for
about a week from a small point, but the swelling
had disappeared, and he was able to attend to his
business.
My second case was a gentleman who sent for
me to call and see him. I found him walking the
floor in apparently intense pain. He said he had
not slept for a week from inflammation and pain in
his hand, which I found enormously swollen, the
swelling and pain extending up the arm. He had
been poulticing his hand from the commence-
ment, and his hand was so swollen that he had
no pitcher in the house large enough to admit
it, and had to use a jar. After lancing his hand —
there was no pus — he put it in the jar, which
I filled to above the wrist joint ; I then added about
an ounce of Hamamelis, also giving him some Aco-
nite to take once an hour. He then laid down
on the bed in such a position that he could keep
his hand in the jar. The next day I called and
found him a very happy man. He said it was not
fifteen minutes after he put his hand in the jar be-
fore the pain entirely left, and he went to sleep.
There was a slight discharge of pus for a week and
the hand had a swollen and doughy appearance for
about the same time, but under the use of Hama-
melis it was entirely well in less than three weeks,
and no more pain attended it.
W. Freeman, M. D.
Electricity in Chronic Constipation. — A few
months since, I was called to a lady who had been
suffering from constipation for nearly twenty years.
She was 36 years old ; had been treated with strong
cathartics, and enemas having finally lost their
power, been told that she must rely upon the former
during the remainder of her life, as the only palli-
ative of which the case admitted. The cathartics
in question, which, in temporarily relieving, had, as
I learned from the patient, materially aggravated
the disease, were at once discontinued. It was pro-
posed simply to aid nature by improving the circula-
tion, strengthening the digestive organs to do their
work more efficiently, and giving new tone to the
lower bowels. In one week, her general condition
was perceptibly improved. In two months, this
initial amelioration had so far proceeded to a perfect
cure, that a brief additional period had already been
fixed by me and announced to the patient, as the
time when further ministrations would be super-
fluous; but at this point the subject became enciente,
which necessitated a discontinuance of the mode of
treatment. She has, however, been doing remark-
ably well since.
The second case was that of a young lady of
twenty years, who had been suffering from constipa-
tion for two years. Cathartics had not been ex-
hibited, as she was strongly averse to that system of
medication. Homoeopathic treatment had, appa-
rently, ceased to be of avail in the hands of a very
competent practitioner, The clyster was the only
resort, though it had almost entirely ceased to be
efficient. I immediately forbade the use of enemas;
administered two treatments per week for two
weeks, and finding the improvement at the expira-
tion of that time not as rapid as had been antici-
pated, increased the number of treatments to three
per week. There was no action from the bowels
after the commencement of the exhibition of elec-
tricity, for nine days. 1*he motion which then oc-
curred was difficult and not large. But, neverthe-
less, the tonic and restorative effect of the new treat-
ment upon the general powers of the patient (a
naturally nervous person, in a highly nervous con-
dition when I was first called to her, complaining
of mental depression as well as physical debility)
was so marked, that no discomfort was experienced
from waiting so long for a movement, while the de-
pression and debility alluded to were very sensibly
relieved. From the first movement, the bowels be-
gan gradually, but steadily, to go back to a healthy
condition. Six days elapsed between the first and
second motion, four between the second and third,
and so on till the end of the cure, which was com-
pleted in seventy days. Since then, the patient has
been in perfect health.
In both of these cases the process of treatment
was the same.
With the negative S. C. at the rectum, the posi-
tive through a sponge electrode, in the hands of the
operator, five minutes on the back of the neck, and
over the pneumogastric nerve, and five minutes
more down the spine. Then ten minutes overjihe
liver, spleen, stomach and abdomen. Here, the
pole was reversed for ten minutes, the negative
being above and the positive at the rectum. During
the treatment, the rectal electrode was three or four
times used with the negative pole for five minutes,
while the positive was applied over the abdomen.
The only drug used was an occasional dose of nux
vom. of the 30th. In both cases, the treatment
was administered three times per week. In the
second of them, four months have elapsed since the
patient was discharged as cured, and the bowels
continue perfectly regular, with sound, general
health. L. G. Fillette.
Phytolacca Decandra. — This remedy, though al-
ready incorporated in our approved list of medicines,
has by no means as yet acquired the credit it justly
deserves, on account of the wide range of diseases
with which it enters the list as a victorious com-
batant.
I will therefore cite a few cases, somewhat dis-
similar in character, which it has cured almost
unaided.
Syphilis inveterata. — This was a case of five years
standing. The patient, A. D., a German of healthy
parentage, 3 1 years old, had an acute attack of sy-
philis, in November, 1862. He was cured!! in about
five weeks by the ordinary treatment with mercu-
rial remedies. This was followed in the spring
of 1863 by a severe attack of rheumatism, treated
with Colchicum, Lithium, and sulphur baths. After
his recovery he continued to complain of pain
in his bones, and a constant aching in the joints,
accompanied with swelling. In the fall of the same
year, syphilitic sores made their appearance on both
his arms and legs. He was then treated with mas-
sive doses of Iodide of Potassium, Merc. Biniodide,
and was again directed to use the sulphur bath.
He continued under this treatment for three years
The Medical Union.
45
with varied success. Sometimes the sores would
heal and remain so for several weeks ; but after any
indiscretion in his diet or mode of living, would
break out again with more or less virulence, until
after having continued under this treatment for
three years, the ulcers assumed an obstinate chronic
form, and spread gradually but constantly until they
covered nearly the whole of the arm and leg.
Disgusted now with his hitherto unsuccessful treat-
ment, he applied to another physician, who treated
him externally with earth, and internally with Ars.
6th and Kali bichrom. 6th. He now began to im-
prove, and for a time it seemed that the ulcers
would heal kindly, while his general health improved
rapidly. But after an excess of indulgence at a large
dinner-party, during which he partook of an unusual
quantity of champagne, he had an attack of rheu-
matic gout; and after that the ulcers broke out with
renewed vigor, and proved to be excessively stub-
born. Ars. and Kali bichrom. made no impression
any more; Baptisia, Cornus and Myrica were now
tried, but all without any good results except probably
the latter. The patient was now sent to me, with the
request to do the best I could for him. I found the
ulcers from one-half of an inch to three inches in
size, irregular in shape, with ragged edges, and the
surface studded with minute granulation which
bled readily. The ankles and knees were swelled
and inflamed, the skin over the swelling glistening
and exceedingly sensitive to the touch. The tongue
clear, bowels regular, urine turbid, with an ex-
cess of uric acid, pulse 95, little appetite, and very
restless at night, but quiet, though feverish during
the day. Gave Rhus-tox. 6th and Bell. 12th, one drop
dose every two hours for two days. He slept well
and the pains in the knees and ankles were much less.
Gave now Phytolacca dec. two drops every two hours,
and nothing else. Externally, an application of Phy-
tolacca, dissolved in diluted glycerine. After two
weeks uninterrupted treatment with this remedy,
the ulcers had diminished two-thirds in size and were
covered with a healthy granulation. Continued the
external application and gave the Phytolacca every
four hours ; steady improvement. Five weeks after
the commencement of the treatment the ulcers were
healed, the knees and ankles normal in size and ap-
pearance, and the general health apparently very
good. Ordered the Phytolacca to be continued twice
a day for three months. No further breaking out of
ulcers after that, neither has he thus far been
troubled again with rheumatism. But Phytolacca
has proven itself also of great value in other dis-
eases, and wrought as striking cures as this, of which
more hereafter. C. E. Blumenthal, M. D.
Homoeopathic Recognition. — The faculty of
the St. Louis Homoeopathic College won aparge
victory, after several persevering efforts. The Board
of Health has granted them one day in each week
to take their students to the City Hospital for object
lessons, but are not to interfere with the Allopathic
treatment practised there.
Subsequently to this action of the Board of Health,
the faculty of the Homoeopathic Medical College of
Missouri appointed Dr. E. C. Franklin, Professor
of Surgery in that College, to fill the position
granted by the Board of Health. Dr. Franklin
visits the City Hospital with ^the Students of the
College every Wednesday, from n to 12 A. M., for
purposes of object lessons and clinical teaching.
Scientific iBleanings,
Paper Lamp-Shades. — Dr. Mirus mentions two
cases in Iowa and one in Frankfort, where persons
using green glazed paper lamp-shades were poisoned
by the arsenic of the coloring matter. The heat of
the lamp volatilized the arsenic and rendered the
small quantity present very dangerous.
War and Insanity. — It was supposed that the
disasters attending the late war had had the effect
of increasing the number of insane persons in France.
Statistics, however, do not confirm this conclusion.
In 1869-70 there was admitted into the asylums
1-1,165 patients, whereas, for the year of the war
and the insurrection, the number was 10,243. The
asylums now contain 3,000 less patients than in 1869.
A New Cause of Diabetes Mellitus. — In
the Archiv fur Anatomie und Physiologie, Drs.
Bock and Hoffman have stated that an injection of
a weak solution of common salt into the carotid
or crural artery of a rabbit, produces diabetes mel-
litus. First polyuria takes place, then comes the
sugar, which reaches a maximum quantity, and then
gradually ceases. This is suggestive of Natrum
mur. as the homoeopathic remedy.
Depilatory. — Prof. Boettger recommends the
following as safe : One part of crystallized sulphy-
drate of sodium is rubbed to a very fine powder,
and mixed with three parts of prepared chalk. The
mixture keeps well in closed vials. Mixed with
water and applied to the skin, the hair becomes soft
in two or three minutes, and is readily removed by
water. A longer application is apt to corrode the
skin. — N. Jahrb. Z. Pharm., Oct., 1872.
Blood in Eruptive Diseases. — A microscopic
examination of the blood of persons afflicted with
measles and scarlet fever, says Dr. Hallier, disclosed
the presence of minute cell-like spores or fungi.
The perspiration collected from these patients was
also found to contain these peculiar and character-
istic micrococci in abundance. Dr. Hallier believes
these fungi are not only the concomitants but the
cause of these diseases.
Glycerine. — Friedel and Silva have produced
glycerine by passing the vapor of fusil oil through a
red hot tube, forming propyler. This combines with
chlorine and from the chloride of propyler thus
obtained glycerine is produced, by a process in
which no glycerine is employed. As glycerine is
the base of all true fats, this is an'important step in
the direction of oil making.
A Case of Transfusion is reported in The
Richmond and Louisville Medical Journal, Dec,
1872. It was performed by Dr. J. Francis King, in
the City Hospital of Wilmington, N. C. The case
was one of gangrene and tetanus following amputa-
tion of the left leg. The blood was obtained from the
carotid artery of a lamb, which was connected by
means of glass tubes with the cephalic'vein of the
man. The patient was unconscious, cold and
nearly pulseless. In a few moments consciousness
returned, and the patient complained of suffocation.
The tubes were now withdrawn and six ounces more
of blood were injected by means of a syringe. There
was great improvement for several days, but the old
condition returned again, and the patient died on
the fourteenth day after the operation.
46
The Medical Union.
Chloral in Venereal Ulcers. — The Gazzetta
Medica Ital. Lomb. announces that Dr. Accetella
uses a concentrated solution of chloral to ulcers
that have resisted the application of powerful caus-
tics as the acid nitrate of mercury. After the first
application the deep parts of the ulcer become
detached, and healthy granulations spring up. To
cure abrasions and simple ulcers a weak solution
should be employed.
Value of Apomorphia in Cases of Poison-
ing.— Dr. Loeb (Apoth. Zeitung, 1872, No. 45)
relates a case of poisoning of a young man who had
swallowed a portion of a solution of oil of bitter
almonds. Half an hour afterward the patient was
found with a livid countenance, rational, but very
weak, vision impaired, pulse 96, heat of body not
altered. A subcutaneous injection of apomorphia,
y% gr., produced emesis in eight minutes, which was
repeated in five minutes. The young man felt better
at once and was well the next morning.
Cysts in the Liver in Childhood. — Bouchut
(Gaz. des Hop. 8, 1872) made an observation on a
girl of eleven, who was brought into Hopital des
Enfants Malades, with a severe pain in the right
hypochondrium and a swelling in the same locality.
The tumor had grown gradually in six months, so
that a notable raising up of the ribs was perceived
in the region of the liver. The increase in size of
the liver was in the right lobe, in which an elastic
fluctuating tumor was perceptible to touch. The
child was thin. Dieulafoy's aspirator drew off 85
grammes of saltish serosity. A few days after
pleurisy ensued, but the child recovered.
Relations of Local Diseases to the Na-
ture of the Soil. — Dr. Moffat, in a paper read
before the British Association, shows that the nature
of the soil exercises great influence on the character
of endemic disease. Anaemia is the prevailing
condition of the inhabitants of the carboniferous
land, while it is almost unknown on the red sand-
stone. Consumption is also more prevalent in the
carboniferous district. Dr. Moffat examined the
constitution of wheat grown on the Cheshire sand-
stone, and found it produced much more ash, and
hence a larger proportion of mineral constituents,
including oixde of iron, than that grown on the car-
boniferous soil. He estimates that a pound of
wheat from the first furnishes five grains more of
oxide of iron to the consumer than a pound of wheat
from the second soil. An examination of the blood
of animals kept in the two districts confirmed the
above observations.
Treatment of Fibrous Tumors of the
Uterus by Subcutaneous Injection of Er-
GOTINE. — Subcutaneous injections of ergotine have
been used already in various affections, particularly
against aneurisms, by Langenbeck and Albanese,
and against hemorrhage (menorrhagia chiefly), by
Ruben and Zeute. Dr. Hildebrandt has gone fur-
ther, and tried ergotine injections against fibrous
tumors of the womb. He at first, however, had
only made use of that means against the hemorrhage
brought on by such a tumor. An unhoped-for re-
sult crowned the treatment, as the tumor, which
was very large, gradually diminished, and at last
disappeared in about fifteen weeks. Except during
menstruation, daily injections were made with 3
parts of ergotine, dissolved in *]%. of glycerine and
7>£ of water. The amount injected was the whole
of a Pravaz syringe. In five or six other cases, the
treatment was nearly as successful. In two cases,
however, symptoms of poisoning by ergotine oc-
curred, and the treatment was abandoned. — Berliner
Klinische Woe hensc hrift, June 17, 1872.
Anchylosis of the Hip Joint was lately
treated by subcutaneous section of the femur be-
low both trochanters, by Mr. Gant, in a case occur-
ring at the Royal Free Hospital. The Lancet gives
the surgeon's reasons for preferring this mode of
operating over the ordinary methods, as follows :
" I. On the pathological ground that the section is
not made in a diseased portion of the femur, but in
a sound and healthy bone. 2. For the anatomical
reason that the resisting psoas and iliacus muscles
are set free. Further, that there is no risk of
atrophy or necrosis of the head of the bone from
cutting off its vascular supply. If successful, Mr.
Gant thinks that this operation will be applicable
(instead of excision) to a class of hip-joint cases,
where the disease is quiescent, but the limb useless
from anchylosis and malposition." The result of
this case (operated upon Dec. 10th, 1872) will ap-
pear in due time.
Ingrowing Toe-nail. — By Dr. G. Stillwell.
— Forty years since, when I was an assistant, a
young farmer one day came to the surgery, and was
operated upon for an ingrowing toe-nail. This was
done by tearing the nail away. The poor fellow
suffered so severely that I was induced to say, " I
will never perform that operation." Of course, in
many years' active practice, I have had many such
cases under my care ; and my invariable mode of
proceeding has been to find the edge of the nail with
a probe, and then remove the whole of the granula-
tions and hypertrophied cellular tissue on both sides,
if requisite. In no case have I been disappointed,
or ever had to treat the patient for a return of this
grievous complaint. I fully expected that this mode
of treatment was general; but my attention has
been recently drawn to the case of a fine young man
rendered almost a cripple, by having had both his
great toe-nails torn out, leaving the overlapping skin
to such an extent as to prevent healing, with the
probability of return on the growing of a new nail.
— British Medical.
Muriate of Ammonia is used by Dr. W.
Stewart {Indian Medical Gazette, Aug. 1, 1872),
with remarkable results in the treatment of chronic
diseases of the liver. After a few doses the patient
often feels a very sudden and sometimes severe pain
in the right hypochondriac region, often a feeling
of shock ; this does not recur, but there is very con-
stantly a drawing sensation in the region of the liver.
The skin rapidly clears up under the influence of
the drug, appetite and sleep return, hectic fever, if
present, vanishes, and the gloomy despondency of
the patient gives place to hopefulness. The medi-
cine often produces free perspiration and also diu-
resis. To induce this favorable change, however,
the muriate must be steadily given from six to ten
days, as its action does not sooner become apparent.
The dose is twenty grains two or three times a day.
When there is a chronic enlargement of the viscus,
the administration should be persevered in for weeks,
and even months, and the liver will, in nearly all
cases, gradually shrink away to its normal size.
The Medical Union.
47
The Post-Mortem of Napoleon III. — The
following is the official report of the doctors who
made the post-mortem examination: "The most
important result of the examination was that the
kidneys were found to be involved in the inflamma-
tory effects produced by the irritation of the vesical
calculus (which must have been in the bladder
several years) to a degree which was not suspected,
and if it had been supposed could not have been
ascertained. The disease of the kidneys was of two
kinds ; there was, on the one hand, dilation of both
ureters and of the pelvis of the kidneys ; on the left
the dilation was excessive and had given rise to
atrophy of the glandular substance of the organ.
On the other there was sub-acute inflammation of
the uriniferous tubes, which was of more recent
origin. The parts in the neighborhood of the
bladder were in a healthy state ; the mucous mem-
brane of the bladder and prostatic urethra exhibited
signs of sub-acute inflammation, but not the slightest
indication of injury. In the interior of the bladder
was found a part of a calculus, the form of which
indicated that half had been removed. Besides this
there were two or three extremely small fragments,
none of them larger than a hemp-seed. This half
calculus weighed about three-quarters of an ounce,
and measured i% by i 5-16 of an inch. There was
no disease of the heart nor of any other organ,
excepting of the kidneys. The brain and its mem-
branes were in a perfectly natural state. The blood
was generally liquid, and contained only a very few
small clots. No trace of obstruction by coagula
could be found either in the venous system, in the
heart, or in the pulmonary artery. Death took
place by failure of the circulation, and was attributed
to the general constitutional state of the patient.
The disease of the kidneys — of which this state was
the expression — was of such a nature, and so ad-
vanced, that it would in any case have shortly
determined a fatal result." Signed by all present.
J. Burdon Sanderson, M. D., Dr. Conneau,
Dr. Le Baron Corvisart, Henry Thompson,
J. T. Clover, John Foster.
SIR WILLIAM GULL'S OPINION.
Sir William Gull left Camden Place as soon as
the autopsy was over, and was not present at the
careful consideration and discussion of the facts
which ensued by the other medical men assembled.
He records a separate opinion on one point only,
viz., the orgin of the calculus, in the following
terms: "I desire to express the opinion that the
phosphate of lime calculus, which formed the nucleus
of the mass, was the result of the prior cystitis (ca-
tarrh us vesicas), and not the cause of it. This nu-
cleus was of uncertain duration, and may even have
been more recent than supposed in the appended
report. However this may be, it was encrusted by
two distinct and recent formations of crystalline
phosphate. The inner incrustation around the
amorphous phosphate of lime was dense and sep-
arated from the outer incrustation by a lesser cel-
lular but crystalline deposit of triple phosphate. It
seems to my judgment more in accordance with
clinical experience to regard the cystitis as the prior
lesion, and that this, by extension, as is common in
such cases, affected subsequently the ureters and
pelvis of the kidneys. No doubt, in the later stages
of the malady, the calculus, by its formation and
increase, was an augmenting cause of the lesions.
The other facts and statements I entirely endorse."
Kew$ 3tem$.
Iowa is the fifth State to legalize dissection.
Eighty thousand people died of cholera last
year in Russia.
A College of Pharmacy has been organized
at Nashville, Tenn.
Prof. E. C. Franklin, of St. Louis, reports a
case of ovarian tumor cured by electricity.
Dr. Austin Flint is the new President of the
New York Academy of Medicine.
The Poppy Cultivation for the production of
opium, in Tennessee, has proved successful, the
plants being superior to the foreign grown.
Dr. Treitz, Professor of Anatomy in the Uni-
versity of Prague, has committed suicide by means
of cyanide of potassium.
Holloway, of " patent pill" notoriety, is about
to build in England an insane asylum at a cost of
nearly ^100,000 ($500,000).
The New England Female Medical Col-
lege of Boston has been made a branch of Harvard
University.
The Empress of Austria has offered a prize of
100 florins to anybody that saves a human life in
Austria or Hungary.
Drs. Fordyce Barker and T. Gaillard
Thomas have been elected honorary Fellows of the
Obstetrical Society of London.
The International Ophthalmological
Congress will hold its next meeting in New York
in 1876.
Southern Ohio Lunatic Asylum. — Dr. S. J.
L. Miller, of Cincinnati, has been appointed Super-
intendent of this Asylum.
Women Students. — Out of 400 students attend-
ing the University of Zurich, 80 are ladies. Most
of them are medical students, and a majority of
them from Russia.
Insane Asylum of California. — The Com-
missioners appointed to select a site for the new
Insane Asylum for 500 patients, have selected the
vicinity of Napa City.
Insane Asylum, Ward's Island. — Dr. Halleck
was lately appointed Chief Physician of this Asylum,
with instructions to examine its condition, and re-
port the changes necessary for its efficient manage-
ment.
Dr. Daremberg, Professor of Medical History
at the Faculty of Paris, recently died, aged 5 5 years.
He was the author of Histoire des Sciences Medi-
ca/es, also of many medical treatises, and translator
of the works of Hippocrates, Oribasus, and Galen.
The St. Louis Academy of Homceopathy was
organized on the 25 th of October last, with the fol-
lowing officers : R. A. Phelan, M. D., President;
C. H. Niebelung, M. D., Vice-President; F. R.
Moore, M. D., Treasurer; J. M. Kershaw, M. D.,
Secretary. Meetings are held monthly.
Large Fees. — Dr. Pitha, of Vienna, has re-
ceived a fee of 100,000 florins ($50,000) on the
recovery of young Baron Todesco, only son of a
millionaire. Mahomet Ali-Bey, an Arab surgeon,
who cured the mother of the Khedive of Egypt, of
a serious malady, has received a fee of $5,000 from
his patient, and has been raised to the rank of Pacha.
48
The Medical Union.
The Philadelphia Jewish Hospital has been
open two years, and has received subscriptions to
its building fund of over $48,000. Seventy-four
patients were treated last year.
Homceopathic Medical Society of Pennsyl-
vania.— The eighth annual session will be held
at Harrisburg, February 5th and 6th, 1873. Dr. B.
W. James, the president, will deliver the opening
address, and Dr. Thomas Moore, of Germantown,
the annual address. The secretaries of the society
are Dr. M. M. Walker, of Germantown, and Dr. P.
Dudley, No. 684 12th street, Philadelphia.
University of New York — Medical Depart-
ment.— A meeting of the medical graduates of the
University was recently held to discuss measures for
elevating the standard of medical education in this
institution. A committee was appointed to prepare
a plan for establishing an endowment fund, thus
rendering the medical (like the undergraduate) de-
partment independent of students' fees.
National Medical Library. — The Surgeon-
General of the United States is desirous to add to
the Medical Department of the National Library
copies of American Homceopathic publications. The
Hahnemannian Monthly publishes a list in its last
number (January) of homceopathic journals wanted
to complete sets. Dr. R. I. McClatchey, 918 North
Tenth street, Philadelphia, will receive any dona-
tions for the library, or purchase such publications
as are deemed suitable.
Albany Union University. — The Albany Law
School, Dudley Observatory, Albany Medical Col-
lege and Union College, have lately been united un-
der the above title, each institution, however, retain-
ing its corporate name intact, the lectures being
delivered in Albany. The inaugural exercises of the
new University and the thirty-fifth annual com-
mencement of the Albany Medical College took
place on the 23d December. Dr. Potter, the Presi-
dent of Union College, is spoken of as Chancellor
of the new University.
Homoeopathy in Jamaica. — The Governor of
Jamaica, West Indies, has discovered that a Cuban
patient, suffering from small-pox, and under the
care of a Cuban Homceopathic physician, was re-
cently taken, by authority of a local law, from the
homceopathist, by a local practitioner, and that the
patient died. The Cuban refugees, therefore, afraid
of similar interference on the part of the local prac-
titioners, concealed their cases of sickness, and the
Government have since discovered, on investiga-
tion, that of six cases which were thus concealed and
treated by Cuban practitioners, all recovered. A
bill is therefore to "be introduced abolishing the
present medical monopoly.
Western Homceopathic Dispensary. — The
reports of the House and Visiting Physicians to
the trustees of this institution at their last annual
meeting, in January, 1873, exhibits in a very gratify-
ing light the prosperity of the Dispensary and the
amount of work accomplished. 17,338 patients were
treated during the last year, and of these 2,423 were
visited at their homes, showing an increase of 1,324
over the number treated the previous year. The
Department of Diseases of the Eye, Ear and Throat,
established last year, under the care of Dr. W. N.
Guernsey and his assistants, has proved a signal
success, administering to a pressing want and afford-
ing an excellent field for clinical instruction. Dr.
Rickaby, the visiting physician, to whom this in-
stitution is indebted for most active work in its
behalf, made 5,190 visits to the out-patients of
the Dispensary. We learn from Dr. Deyo, the
house physician, that an examination of the total
expenses of the institution shows that the average
cost of treating the patients was 17 cents apiece.
This is one basis for the claim of the trustees, viz :
that the Western Homceopathic Dispensary is the
most efficient organization of its kind in existence.
New Journals. — // Galvani is the title of a new
monthly journal to be published at Urbino, Italy,
this year, to be specially devoted to electro-thera-
peutics
— The Central New York Medical Journal. —
Dr. Ely Van de Warker, of Syracuse, proposes to
issue a new monthly under this title, to be the offi-
cial organ of the Medical Association of Central
New York.
— The Archives of Scientific and Practical Medi-
cine, is the title of a new monthly journal just issued
— Drs. Brown-Sequard .and E. C. Seguin are the
editors, and Lippincott publishes it at $4.00 per
year — "purely controversial, and editorial articles,
proceedings of societies and news, will be altogether
excluded."
Homceopathic' Medical Society ^of^'the
State of New York. — The twenty-second annual
meeting of the Society will be held in Agricultural
Hall, corner of State and Lodge streets, Albany,
Tuesday and Wednesday, February nth and 12th,
1873.
First Day. — The morning session of the first day
will commence at 10 o'clock. During this session
honorary and permanent members will be elected;
the business, nominating and other committees will
be appointed, and the report of the Treasurer will
be presented.
The afternoon session will be occupied in'Ithe
presentation and reading of such portions of the re-
ports from the several bureaus as the Business Com-
mittee may designate.
The annual address will be delivered in the As-
sembly Chamber, at 8 o'clock in the evening, by J.
W. Dowling, M. D., of New York.
At the conclusion of the address, the members
will adjourn to Congress Hall, where a collation will
be tendered them by the members of the Medical
Society of Albany County.
Second Day. — The Wednesday morning session
will commence at 9 o'clock. The first business will
be the election of officers ; after which, and during
the remainder of the day, the time will be devoted
to the presentation of reports by the Bureaus, and
the discussion of such subjects as may be recom-
mended by the Business Committee.
It is very desirable that the profession from all
parts of the State be represented at this the annual
meeting of the Society. It is especially important
that delegates from all the County Medical Societies
be in attendance to represent their local interests,
and to present a report communicating the results
of their experience in the treatment of prevailing
diseases, trials of new remedies, histories of epi-
demics which may have been prevalent in their re- (
spective localities during the past season, reports of
provings, and papers on any subject relating to
medical science.
The Medical Union,
49
iDriginat Articles.
PETROLEUM-
ITS ORIGIN AND RELATION TO
MEDICINE.
By Robert A. Chesebrqugh.
No. II.
It is remarkable, that notwithstanding the fact
that petroleum has been used as a medicine for cen-
turies, that so little attention has been given by the
. medical profession to its curative properties, their
value and extent, and to the elements on which
these properties depend. That they undoubtedly
exist, is proven by the fact that savage, as well as
civilized nations, testify to their value; and if the
axiom that "time proves all things" can be admit-
ted here, petroleum as a medicine has stood the test
of ages and is therefore, on its antiquity alone, well
worthy of a prominent place in modern pharmacy.
It is doubtful if any substance now in use by the
profession can show as old a title. The Persian fire
worshippers, the Ghebers of Bakoo, while using it
in their religious rites, on their blazing altars and in
their funeral-piles, also use it medicinally. The
Egyptians used it in embalming the dead, and as
an arrester of animal and vegetable decay; and
from it was also made the Greek fire of ancient war-
fare. In India it has been used for centuries as a
liniment for cutaneous disorders, and for preserving
timber from the ravages of insects. In this country,
the first knowledge of petroleum was derived from
the Indians, who highly prized it for its medicinal
properties, as also for its use as a component of war
paint with which they ornamented their faces and
bodies. It was then known as "Seneka," or Sene-
ca oil, an appellation yet preserved.
More recently it has been considerably employed
in medicine as a sudorific and antispasmodic, and
as a remedy for tape-worm. Externally, it has
been used for cutaneous disorders, rheumatism,
affections of the joints, chilblains, etc. At best,
however, its use has been extremely limited, espec-
ially by the regular physician, owing probably
to the indefinite and irregular results obtained, and
a want of general information regarding it, its
preparation, the kind of oil to use out of the several
varieties, and also, on what its curative properties
are based. We shall endeavor to answer these
queries briefly, and to give the physicians such
limited knowledge as we possess; and if it shall
serve to ameliorate in the least degree, the cause of
suffering humanity, we shall feel well repaid. It
should be understood that the writer of this article
is not a physician, or a student of medicine, and
that even his knowledge of it as a science, is entirely
casual and superficial
We have already stated that petroleum is com-
posed of hydrogen and carbon, and assuming our
hypothesis of its origin to be the true one, we may
also assume that, as formed, it is colorless and free
from organic matter. The organic matter it con-
tains is due to the impurities with which it has
been mixed and contaminated in its passage upward
toward the surface of the earth, and its color may
be due to these impurities. In a measure, this may
be proven by the fact that occasionally petroleum
is found almost free from color — of a yellowish
tinge — instead of the deep greenish black color
which it ordinarily presents. Again, in some
places it is found impregnated with a suffocating,
sulphurous, arsenical odor, and in other places,
quite free from any disagreeable odor whatever.
It is natural to suppose that these variations of
color, odor, and impurity are attributable to the
character of the strata through which it passes.
It will therefore at once be admitted that the
inherent curative properties of the substance may
readily be neutralized by organic impurities ; and
consequently, it is important to know what oil
is most free from them, and how they should be
eliminated where they exist. We find that petro-
leum has, so far, been used medicinally, almost alto-
gether in its crude state, the ordinary known process
of ^refining — viz., by distillation and chemical treat-
ment— appearing to destroy its curative properties.
In the crude natural state it is offensive as a lini-
ment, and exceedingly so if prescribed for use intern-
ally. By a process recently discovered, petroleum
has been brought to such a condition that its full cu-
rative powers are preserved, the objections to its use
removed, and the physician enabled to carefully test
its effects with satisfaction. This process is briefly
as follows: The crude oil is highly concentrated,
the bulk of the hydrogen being driven off by simple
heat without distillation ; the product is then care-
fully and repeatedly filtered through bone-black, or
animal charcoal, and the result is a pearly white
substance of the consistency of butter, which is free
from all odor and chemically pure.
Experiments of considerable extent have not only
demonstrated conclusively the high value of the sub-
stance (so prepared) for medicinal use, but they have
led to conclusions as to on which element constitut-
ing the petroleum we must depend for the cure. We
unhesitatingly assert that it is principally upon the
carbon contained in it. The antiseptic properties
of carbon are well understood, and its power of
arresting decay acknowledged ; and we claim that
to this petroleum principally owes its chief value
as a medicine. We know that it is destructive of
insect life, and may reasonably conclude it is also so
of epiphytes and fungus germs. If, as science
would now seem to indicate, acute epidemic and
miasmatic disorders are attributable to microscopic
fungi which are absorbed into and prey upon the
human system, and which theory (we may be ex-
cused for saying) seems to us to offer the only lucid
and comprehensible explanation of epidemic and
contagious diseases, the concentrated antiseptic
carbon of petroleum may yet offer to the world a
barrier against the attack of these diseases and
prove an incalculable boon to humanity.
If our premises are correct, viz., that the virtue of
the petroleum as a medicine is in its carbon, then it
follows that independently of the organic impuri-
ties which may neutralize its value, it would also be
erroneous to administer petroleum of a density
which contains an excess of hydrogen. And yet we
opine that in three cases out of four, the light
density oil has been used, simply because it was
supposed to do the work, was petroleum, and could
be purchased at one-third the* price by the apothe-
cary. It will be well to state here that when crude
oil is used either as a liniment or internally, the
best and most effective is that which comes princi-
pally from West Virginia, of a gravity of about 30^,
Beaume's hydrometer, discarding the Pennsylvania
oil, and absolutely rejecting the Canada crude as
almost poisonous, on account of its dangerous im-
50
The Medical Union.
purities. We are not prepared to say to what ex-
tent crude petroleum may be administered intern-
ally without injurious effect, nor can we find in the
books, that it has been s6 given in large doses : but
from experiments with the filtered concentrated oil,
we do not hesitate to pronounce it in the highest de-
gree innoxious. A lady, suffering acutely from
asthma, induced by water on the lungs, preceding and
after labor, took inwardly, some sixteen ounces during
four days without experiencing the least ill effects. In
fact it appeared to be the only thing which would af-
ford relief; and at the end of this period the asthma
had entirely subsided.
It has been used with exceedingly satisfactory
results in croup, sore throat, coughs, and even con-
sumption, the relief being prompt and permanent.
As a liniment for sores, ulcers, cutaneous affections,
rheumatism, piles and catarrh, the testimony as
to its value is voluminous. The immediate relief
it will afford to burns or scalds is surprising; and as
an emollient its properties are much superior to
glycerine The above described process of pre-
paring petroleum for medicinal use accomplishes
two important things. First, by concentrating it,
the excess of hydrogen is driven off, which appears
to be a detriment; and second, what remains is
deprived by the filtration of all impurities and color,
and restored to what we believe to have been its
original condition as formed in the earth.
All organic coloring matter acts as an acid base,
and this is essentially true of petroleum, and the
fact that the filtration attacks and removes the
color, leaving the petroleum neutral, is a proof that
the coloring matter is foreign to the substance itself
and not a component part of it. The process of
filtration used is almost identical with that in use
for refining sugar — we state this simply to show its
entirely unobjectionable character.
Experiments are now in progress to accurately
determine the value of this substance as a medicine,
and the results obtained will be given to the world
by those better able to judge of its merits than the
writer of this article. We predict, however, that
ere long the pharmacopoeia will enter upon its
honored annals a new name, and one destined to
sustain a high and worthy place in medical esti-
mation.
Remarks by the Editors.
Petroleum has long been used by the Allopathic
school, but in a purely empirical manner. We have
in our materia medica quite an extensive proving of
it, and it is recommended by Hahnemann in various
forms of chronic diseases. Its disagreeable odor
and the uncertainty of its action has, however, to a
very great extent, excluded it from general practice.
Mr. Chesebrough explains the cause of its disagree-
able odor, and the uncertainty of its action. As
now prepared in its concentrated form, it is without
odor and almost tasteless. We have used it in
bronchial and laryngeal irritations, in various forms
of eruptive troubles, and as an external application
in arthritic swellings with very decided success. We
have also used it locally in vaginal, nasal and aural
catarrh, where the discharge was offensive, and also
where there was great weakness of the parts. We
sent a quantity of the petroleum, to which has been
also given the names of Vasoline and Cosmoline, to
Dr. J. Titus Deyo, the very excellent house physi-
cian of the Western Homoeopathic Dispensary, and
he has given us the following results of his experi-
ments :
" The first application was made with this remedy
in recent pharyngial, laryngeal and bronchial affec-
tions of a catarrhal character. As near as I could
judge, 1 prescribed the Vasoline in doses of grs.
in v, repeated every three (3) hours. With two or
three exceptions, it was productive of relief in much
less time than the ordinary remedies given in these
several troubles. It seemed to remove promptly that
peculiarly distressing, raw, sore condition which is
always present in these affections. It likewise re-
lieved the cough which is excited by the irritation
and tickling sensation in the larynx, which calls or-
dinarily for Kali Bich. I also tried it in similar
cases of longer standing, but did not meet with such
satisfactory results as aforesaid.
"In several of these cases I purposely gave very
large and frequently repeated doses, for the express
purpose of obtaining a clinical proving of the Vaso-
line, in addition to the good effect which I expected
to gain from the administration of the remedy.
Without a single exception, these several cases re-
ported to me improvement in the condition of their
throats and cough, but considerable gastric derange-
ment of the following character: slight nausea; sour
or bitter eructations — spasmodic; some flatulency;
and in two cases, several slimy dysenteric evacua-
tions of the bowels, accompanied with severe, sharp,
cutting abdominal pains. There was also a largely
increased secretion of urine, necessitating the fre-
quent emptying of the bladder. I inquired particu-
larly for a cause for these conditions, but could as-
sign but one, viz : the Vasoline.
"Acting on these data I prescribed it in two cases
of chronic gastric catarrh, but found that even when
given in very small doses it tended rather to aggra-
vate than mitigate the difficulty. I have not the
least doubt but that it will be found to be a valuable
remedy in gastric troubles of a sub-acute character.
I likewise prescribed it in several cases of herpes
and eczema, both internally and externally used, but
must frankly admit that, although the results ob-
tained were tolerably satisfactory, still the ordinary
treatment for this class of ailments seems preferable
to me.
"In chronic arthritic rheumatism I have employed
it with most excellent results, used externally only.
"For the following two diseases I look upon the
Vasoline as being almost a specific: 1st, Chilblains.
Used locally only, it has not only promptly relieved
the very distressing itching, and burning sensation,
but there has been no return of same since ; having
been afflicted with chilblains myself, and having used
this remedy, I can speak thus positively of its effi-
cacy.
"2d, Gleet, that most annoying and troublesome
disease which the profession are so often called on
to treat. Five cases of gleet were healed with the
Vasoline, prescribing it both internally and locally —
internally in quite appreciable doses, say grs. V-X,
three (3) or four (4) times a day; and for the local
application, I recommended the patient to procure
an ordinary sized bougie, or in lieu thereof a goose-
quill, besmear it with the Vasoline, introduce into
the urethra, and allow it to remain for a few minutes
for absorption ; repeating this operation four or five
times a day.
"The effect produced by this treatment was more
marked than from any I have hitherto employed.
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51
In three (3) of the cases it effected a radical cure;
in the other two (2) the result was not so good, by
reason of the mode of life of the patients, and habits
acting adversely to a cure.
" In the local treatment of both acute and chronic
vaginal catarrh, I have likewise had good effects. I
look upon petroleum, in its various forms, as
specially adapted to the treatment of catarrhal
diseases wherever manifested."
Dr. MacFarland, of Philadelphia, under the name
Cosmoline, gives the following report :
"A portion of the Clarified was rubbed up with
Sugar of Milk, and given as a proving to a variety
of persons — using the Third Decimal trituration —
with the following results :
"In all cases, speaking generally, the appetite
failed. There was a feeling of uneasiness and dis-
tress about the epigastrium ; eructations, mouth
filled with sour water, and bowels disposed to be
loose. Several of the persons had diarrhoea (watery
and offensive) on the second or third day; great in-
difference and weariness ; urination was free (pro-
fuse) and frequent.
"The skin symptoms in all the cases were alike-
great apparent dryness of the skin and itchiness
everywhere, with a constant disposition to scratch
one's self In two cases the skin became dry and
scurfy, in irregular patches or blotches, which were
very itchy. The skin, on being scratched slightly,
would rise in welts or blotches.
"In regard to the curative effects of it, I may say
that I have cut short two cases Herpes Zoster, of a
very violent character. The eruption disappeared
in both cases within ten days.
"At the Clinic of the Hahnemann College, and be-
fore the class, Cosmoline has been used with won-
derfully curative effect in the different varieties of
eczema. As far as I know, it is the most reliable
remedy we have in that obstinate disease — Betro-
leum, highly potentized, acting in a similar manner.
"The local application of Cosmoline removes the
stinging, burning and itching of eczema."
Of the same substance, George S. Norton, M. D.,
Resident Surgeon of the New York Ophthalmic
Hospital, speaks as follows :
"Cosmoline has proved very valuable to me as an
external application in some diseases of the eye and
ear — especially in chronic catarrh of the middle ear,
when the membrana tympani is thick, firm and de-
pressed, by dropping in a small quantity of the pure
Cosmoline once a day. It seems to soften the mem-
brane and cause it to take on a more healthy action.
In addition to this I use the indicated internal
remedies.
" I have also used it with benefit in chronic cases of
ciliary blepharitis ; it softens the crusts which accu-
mulate, and is a soothing application to the lids, re-
moving, often, the disagreeable burning and itching
which accompanies this trouble."
We are convinced that Petroleum, as now pre-
pared, possesses rare medicinal properties, and offers
a rich field for the investigation of our, physicians.
Those who wish to test its curative properties, either
in dispensary, hospital, or private practice, can ob-
tain a supply, free of charge, by applying to the
publisher of this journal.
THE TRANSFUSION OF BLOOD.
By John C. Minor, M. D.
The Montpellier Medical Schools have
been closed by order of the French Government.
No reason is given for this step.
The transfusion of blood is a subject whose lit-
erature is confined almost exclusively to the mono-
graphs of German or French authors. In the best
and latest works on surgery, the subject, if men-
tioned at all, is dismissed with such short notice
as to amount to a practical omission, while other
topics of lesser importance are treated with ex-
haustive fullness. It is not my present intention to
make an attempt to supply this deficiency in our
medical literature, but merely to indicate some of
the grounds on which the transfusion of blood
merits a more thorough appreciation at the hands
of the profession than it has yet received. Erichsen,
in his admirable work on the Science and Art of
Surgery, mentions the subject in the following
terms: "If death appear imminent from the effects
of the hemorrhage, as happens in some cases of
flooding, transfusion of blood may be had recourse
to; the influence of which, in restoring the failing
powers of the heart and nervous system, is imme-
diate and most striking, and has been unques-
tionably determined by the observations of Dr.
Blundell and other obstetricians." This extract, it
appears to me, represents the general impression
of the profession very fairly upon this point. Now,
the question may reasonably be asked, whether
transfusion is 10 be used only in cases of hemor-
rhage ? If it be true that its influence in restoring
the failing powers of the heart and nervous system
is immediate and most striking, may we not class it
among the most powerful of stimulants, and use it
as such whenever a powerful stimulant may save
life ? There seems to be, already, sufficient clini-
cal evidence to warrant an affirmative answer
It often seems that but little is required to save a
life. The turn of a crisis is a question of a few
hours, and if we only possessed the means of bridg-
ing over the fearful depression — if we could reach
with our remedies the nervous and vital centres,
we might possibly land our patient on the life side
of his crisis. But in these cases we are generally
powerless. The system fails to respond to the ac-
tion of ordinary remedies. The gates are shut and
the battle is to be waged for life or death without
any interference on our part. The brain is appar-
ently inert, so that moral or mental influence for
good is impossible; the functions of absorption and
assimilation are stopped, so that nourishment and
stimulants cannot be appropriated by the system.
The life of the patient is to be decided by the
strength of his constitution, by his vital force, or
by whatever you choose to call that subtle power
that fights for* life. Now, what is usually done in
such a crisis ? We put hot bottles to the feet of the
patient because the circulation is depressed and his
extremities cold. We apply friction for the same
purpose. WTe try to stimulate him with brandy,
quinine, or carbonate of ammonia ; or, trusting to
the homoeopathic treatment, we administer Arseni-
cum, Veratrum, Camphor, or whatever may be in-
dicated. We come pretty soon to the end of our
resources. The patient begins to sink ; there is
coma ; a cold perspiration on the hands and fore-
head, a thready pulse, growing weaker every mo-
ment till it can scarcely be perceived at the wrist.
So far as anything is to be hoped for from ordinary
practice, the patient is dead.
52
The Medical Union.
I have given, in outline, a case which may be
one of collapse from hemorrhage ; it may be a case
of typhoid fever, of cholera, of septicaemia, of sur-
gical shock, of anything you please, for almost all
diseases present similar aspects in their later stages
when death impends. In this extremity we have
but one resource left, and that is in the transfusion
of blood. When we recollect that it is in just such
desperate cases that transfusion has been used, and
that whatever success has attended it, has been won
in the face of greater odds than were ever brought
against any other remedy, we must acknowledge,
that under these adverse circumstances, a success
for transfusion greater than that attending the opera-
tion for strangulated hernia or stone in the bladder,
and equalling the average of amputations, demands
a careful consideration at our hands. The general
impression, that the transfusion of blood is a most
rational and efficacious remedy against the conse-
quences of profuse hemorrhage is correct, but when
our estimate of the operation is confined to its action
in this comparatively narrow field, it is certain that
we fail in a true appreciation of the clinical facts,
and of the actual demonstration of its efficacy in other
conditions and diseases. It has proved successful
in all kinds of hemorrhages, primary and secondary,
after operations, in those in connection with pla-
centa prsevia, abortion and miscarriages, whether
the hemorrhage was ante partum or post partum ;
in haemoptysis in phthisical patients, and in uter-
ine and nasal hemorrhages dependent upon the
presence of tumors. These cases have been too
easily explained — a certain amount of blood is lost,
and collapse occurs, we introduce fresh blood into
the circulation, restore the balance, and save the
patient. This explanation is, however, incorrect,
since it implies a purely mechanical action for the
operation. If transfusion is simply a mechanical
substitution of a certain quantity of fresh blood, in
order to compensate for an equal loss of that fluid,
we should not only require a pound-for-pound
arrangement, a supply exactly corresponding with
the loss, but we should inevitably fail in every case
of hemorrhage, except in those where the bleeding
vessels could be ligated. Unless there is more than
a mechanical action in the . operation, there would
be no stimulus to the contraction of the blood
vessels, and we should be pouring in blood at the
point of operation, only to have it escape again at
the point of hemorrhage. We find, however, that
the vessels do contract ; that the muscles recover
their power; that patients are roused from the
deepest coma ; that color returns to the lips, and
warmth to the body ; the heart's action becomes
stronger ; the eyes brighten and intelligence re-
turns, and all this wonderful transition from ap-
parent death to life, this resurrection of a patient
in articulo mortis, occurs from the transfusion of an
amount of blood that is perhaps not one-tenth as
large as the amount lost by the hemorrhage. A
purely mechanical action will not explain this effect.
We must acknowledge that it is a stimulant more
powerful and certain in its action than any other,
and that the history of its success in cases of hem-
orrhage alone furnishes us with evidence sufficient
to warrant the conclusion that it would be efficient
as a stimulant in other conditions. But we are not
left to barren conclusions in the matter, for their
correctness has been already proved. In anaemia
and chlorosis, in puerperal convulsions, in septi-
caemia and hospital gangrene, in asphyxia from
poisonous gases, in the extreme exhaustion follow-
ing continued dyspepsia, in scurvy, epilepsy and
cholera, it has proved curative. The list is, to be
sure, a comparatively small one as yet, but it would
unquestionably have been much larger had the pro-
fession generally recognized the fact that transfusion
was applicable to other cases than hemorrhages.
However brief the data may be, one fact stands
prominent and affords the strongest possible evi-
dence of the utility of resorting to the operation
even in doubtful cases, namely: that, with hardly
an exception, every life saved by transfusion has
been utterly beyond the reach of other help. A
large proportion of the patients were in a state of
the most profound coma when the operation was
performed. In one case the patient was not only
comatose; but the pulse in the carotids had ceased
for two hours and a-half before transfusion was
resorted to and her life saved. In many cases that
have been classed among the failures, the operation
was performed on patients who were already dead.
It is acknowledged, then, that transfusion may
be reasonably and efficaciously used in cases of
hemorrhage. Is it not equally reasonable to use it
in cases of blood poisoning ? Take, for instance, a
case of uraemic convulsions. The blood is loaded
with poisonous matter which the kidneys should
have eliminated, but those organs are unable to
perform their proper functions, and hence we have
this toxic material accumulating till it overpoweis
the system and produces the uraemic convulsions,
which, in a large majority of cases, terminate in
death. The condition of the kidneys which leads
to uraemic convulsions is one that may perhaps
be successfully treated, but when the convulsions
once occur, there is no opportunity for such treat-
ment, for the system fails to respond to the action
of remedies, and the patient will probably die in
the convulsions. Would it not be reasonable to
let out some of this poisoned blood and supply its
place with healthy blood ? (I know of but one re-
corded case among the French or German authors,
where transfusion was used in puerperal eclampsia.
The operation was performed with perfect success,
by Dr. L. von Belina, and is reported in his mono-
graph " Die Transfusion des Blutes" page 21.)
Now, it is perhaps true that we do not attack the
real source of the trouble in this case, and, that
after transfusion has dissipated the convulsions, the
kidneys may still be unable to eliminate the ex-
cess of urea, and consequently, the convulsions may
return again and destroy the patient. But we have
at least gained time by the operation, so that there
is a chance to use other remedies. In anaemia
we have a condition which has been frequently
cured, when the patient appeared to be beyond all
hope, by means of this operation. There is no loss
of blood to repair, nor poisoned blood to replace,
how, then, can transfusion benefit the anaemic pa-
tient? Because, with every drop of good blood
that we introduce into the circulation of the anaemic
patient, we inoculate his watery blood with a thou-
sand globules which reproduce themselves, and by
their multiplication restore the proper balance
between the solid and fluid constituents of the
blood. On this ground, Polli (Gazette des H6-
pitaux, 1854, page 6) has advised the performance
of transfusion in scrofulous subjects. We have
in blood, then, certain vital properties that enter
The Medical tinion.
53
largely into the action of this operation ; in partic-
ular we know the blood globules to possess the
power of reproducing themselves, and this power
is not confined to the white globules merely, but is
exerted by the red globules as well. The more
recent investigations of the German pathologists
have revealed the fact that the microscopical ap-
pearance of the blood in patients affected with
syphilis, scrofula, tuberculosis, and some other dis-
eases, is as different from healthy blood as the
external appearance of such patients is different
from that of persons in sound health. These
differences in the blood are in relation to the size,
shape and physiological function of the globules.
As the diseased condition improves under treat-
ment, the blood globules approach nearer the
healthy standard ; as the disease progresses in the
opposite direction, the characteristic appearances
of the blood globules become more marked. It is
ah open question whether the blood itself is not the
true field of the primary action of many of these
diseases ; whether, in fact, what we call the disease
may not be merely the local symptom, the direct
result, of a peculiar shape, size, or conditional action
of the blood globules. In connection with this
view, we must also take into account the results of
other investigations which show the presence of
fungoid growths and various forms of animalculae
in the blood in certain diseases, and that in others
there are chemical changes sufficient to account for
the abnormal condition. We may claim, then,
that in many diseases, and especially in those called
"zymotic," the greatest weight of scientific testi-
mony locates the exciting and continuing causes in
the blood.
These facts are not without their practical bearings.
The nearer we approach the first causes of disease,
the more successfully can we combat it. The treat-
ment of the bites of venomous serpents by injecting a
strong solution of ammonia into a vein, is an instance
in pdmt. The poison of the Cobra da Capello is,
probably, the most virulent of all the Indian serpents.
It produces a profound nervous depression, and rap-
id decomposition of the blood. So long as the efforts
of physicians were directed to stimulating the nervous
system, and attempting to get rid of the poison by
the slow process of elimination, the mortality was
fearful. But when the poisoned blood was recog-
nized as the cause of the nervous depression, and it
was found that the poison could be neutralized by
strong ammonia, the introduction of this agent di-
rectly into the circulation brought the disease and
its remedy face to face, as it were, and the result
has been a signal success.
In septicaemia we have an acute disease due to
the absorption of various putrid substances into the
blood, and pyaemia is supposed to be due to similar
causes. Albanese, of Palermo, has reported three
cases {Gazetta Clinica, &c, Palermo, Giugno, 1869)
of pyaemia which he treated by the transfusion of
blood. It failed to relieve one case ; the second case
was materially benefited but finally died of the dis-
ease ; the third case recovered completely. No other
treatment of pyaemia can show so good a result. In a
recent case of hospital gangrene following an amputa-
tion, where the symptoms, as recorded, show that
there was septicaemia, transfusion was performed, the
patient being in a comatose condition. The operation
was followed by immediate improvement in a very
marked degree, but eventually the same condition
returned and the patient died two weeks after the
operation. It is, perhaps, unwise to venture an ex-
planation of the action of transfusion in these and
similar cases. It seems probable that this operation,
like many other remedial measures, must first win its
position by practical demonstrations, in advance oi
the investigations that will, in time, explain its action.
But it cannot be doubted that there is already suffi-
cient ground to base a rational explanation of its ap-
plication to diseases of widely-varying character.
We know that the blood-vessels absorb fluids from
the intestines more rapidly and abundantly than
even the lacteals, and that in consequence of this
power of absorption the blood becomes rich in sac-
, charine and albuminous matters. The fatty sub-
stances are taken up by the lacteals and discharged
as chyle through the thoracic duct into the subclavian
vein. The blood is, therefore, a nutritious fluid, and
it is probable that in some cases — such as anaemia,
scurvy, emaciation from prolonged suppuration, or
from persistent vomiting — some of the good effects
of transfusion have been due to this highly nutritive
character of the blood. I have already mentioned
the vital properties of the blood globules, by which
they reproduce and multiply themselves, so that the
proper balance between the solid and fluid constitu-
ents of the blood is restored as in cases of anaemia
and chlorosis. There is, besides, the property pos-
sessed by the red globules, of carrying oxygen and
imparting it to the tissues. The respiration of the
muscles is the same in effect as the respiration of
the lungs. They absorb oxygen and produce car-
bonic acid gas, and the supply of oxygen comes
directly from the red globules. The contractility of
the muscles depends mainly upon their supply of
oxygen, and hence we have a clue to the stimulant
action of transfused blood. We have, therefore,
three important properties in blood, which are all
important when we consider its action after transfu-
sion. 1st its stimulant action; 2nd, its vital or
reproductive property ; 3rd, its nutritive quality.
With an intelligent appreciation of these qualities
in the agent used, we may, on purely theoretical
grounds, find it harder to describe conditions in
which the operation should not be performed, than
to specify those in which it should be tried. To my
mind, the presence of organic disease would be no
bar to the operation, from the simple fact that I be-
lieve all diseases are organic, and that the reason
why we call some diseases "functional," is because
we have not yet investigated them sufficiently. Un-
less the diseased condition is accompanied with hy-
peraemia, as in some forms of cerebral apoplexy ;
unless it is the result of a mechanical cause, as in
the coma produced by the compression of the brain
by bone, pus, or extravasated blood ; unless there is
such extensive destruction or alteration of the inter-
nal organs as to make recovery a physical impossi-
bility, as in aneurisms of the larger arteries, in
some valvular lesions and in fatty degeneration of
the heart, in perforating ulcers of the intestines,
&c. ; unless such conditions as these prevail, I can
see no reasonable objection to the transfusion of
blood in cases where death seems imminent, no mat-
ter what the disease may be. Take an example of
organic disease of the most marked kind ; let it be,
for instance, a case of pneumonia. Recovery is
possible in any stage of this disease. Even in the
fatal cases we invariably find, on making a post-
mortem, that nature has begun to repair the dis-
54
The Medical Union.
eased condition, that some portion of the lung tissue,
and generally a considerable portion of it, is in the
stage of resolution. What interrupted this process
of resolution and why did it not progress to a full
recovery when, perhaps, another patient suffering
from the same disease to even a greater degree was
restored to health? " Deficient vitality," " a poor
constitution," "a lack of recuperative power" are
convenient expressions, and true enough, but they
do not give a satisfactory reason for the death
of the patient. There are mechanical obstruc-
tions to the proper performance of the respiratory
action of the lungs, but this obstruction is never
complete, and there is generally enough action,
however impeded it may be, to support life. There
is, also, the exhaustion produced by the suppurative
process. These two causes combined are, perhaps,
sufficient to account for the fatal result in many
cases, and it is possible for either one of them
to produce death. When we find a critical case of
pneumonia, just balancing between life and death,
is it unreasonable to suppose that the effect of
transfusion may result in the recovery of the
patient? The direct and exhaustive drain upon
the blood by the suppurative process can be
more rationally combated by the introduction of
fresh blood than by the indirect and uncertain
action of remedies. The oxygenation of the tissues
by the red globules will act and react with more pow-
er as a general stimulus than any amount of brandy
could do. The nutritive quality of the transfused
blood will certainly be as effectual in giving strength
to the system, as a hearty meal to one who is weak
and famished. The actual degeneration of the lung
tissue — the fact of the presence of organic disease —
is never used as an argument against nourishment
or stimulation. How, then, can transfusion be
objectionable when it brings the most condensed
and active of nutriments, and the most powerful of
stimulants, in the exact form in which they can be
used for the repair of degenerated tissue and the
cure of organic disease ? Now, I have selected
pneumonia as an example of organic disease, not
because I believe it to be one to which the transfusion
of blood is peculiarly applicable, but because it is
one to which this operation would not, perhaps, be
considered as having any relation.
Probably there is not any decided objection on
the part of physicians to the operation, even in cases
of organic disease ; but they regard it as a hazardous
operation, requiring especial surgical skill and in-
tricate apparatus. This view is certainly erroneous.
There must be a reasonable amount of care and
neatness, but not necessarily any great surgical skill
or anatomical knowledge. It is an operation which
any physician should be able to perform. The re-
quirements are very simple. The only instrument
needed, besides those contained in the ordinary
pocket case, is a good syringe, holding at least four
ounces, and having a nozzle that tapers to a pretty
fine point. The syringe will be better for the pur-
pose if the barrel is of glass, so that any bubbles of
air can be seen. Whatever its construction, it should
be in good order, perfectly clean, and work easily.
The steps of the operation are as follows :
ist. Expose the vein of the patient and open it,
the finger of an assistant being placed over the
opening to prevent hemorrhage.
2d. Bleed the person who furnishes the blood,
into a bowl surrounded with cold water, or else de-
fibrinate the drawn blood and keep it at the normal
temperature.
3d. Fill the syringe, expel the air, insert the nozzle
into the vein of the patient, and inject slowly.
As to the first step, it makes some difference what
vein is selected for injection. The jugular vein is
not to be used for that purpose because there would
be more danger of admitting air into the circulation
than if some vessel on the extremities was selected.
Generally one of the veiiis of the forearm, either the
median cephalic, or the median basilic, at the bend
of the arm, is used. The internal or external saphen-
ous vein at the ankle is also an eligible point for opera-
tion. It is not important, with the exception just
given, what vein is selected. Choose the one that can
most easily be reached. If a vein of the forearm is
decided upon, put a bandage around the arm above
the point of operation so that by the compression
thus produced the veins may become more promi-
nent and easily distinguished. Make an incision an
inch in length alongside of the vein, separate the ves-
sel from the surrounding tissues and pass a double
ligature beneath it. If the patient is thin and the
veins large and easily reached, this process of dis-
secting out the vein is not necessary. Seize the vein
with forceps, or lift it by means of the ligature, and,
with scissors, make a V-shaped opening into it.
An assistant's finger should now be placed over the
vein and the bandage on the arm loosened to pre-
vent hemorrhage.
The second step of the operation is to bleed the
person who is to furnish the blood. He should be
placed in a horizontal position so as not to interrupt
the proceedings by fainting; and the blood should
be drawn in a full stream into a bowl surrounded with
cold water of a temperature of 450 to 500 Fahren-
heit. The process of bleeding requires no descrip-
tion. The blood should be drawn in a full stream,
because it does not coagulate so rapidly as when the
flow is slower. It should be drawn into a bowl sur-
rounded by cold water, because the coagulation of
the blood is retarded by cold while the vitality of
the globules is not impaired thereby. Blood at the
normal temperature (920 to 102°) coagulates in
about six minutes. At a lower temperature (450
to 500), it will remain fluid for about half an hour.
By defibrinating the blood it loses its power of
coagulation. The process of removing the fibrin is
very simple. The blood is rapidly stirred or whip-
ped with a clean wisp from a broom brush for two or
three minutes, when the fibrin will be adherent to the
wisp. The blood is then filtered through a fine
piece of muslin into a bowl surrounded with "blood-
warm" water. The water must not be too warm,
for the albumen may be coagulated by the heat.
As to which of these two methods is to be preferred,
I believe there is practically no difference, except
that by defibrinating the blood, the operator is en-
abled to proceed more slowly and perhaps, on that
account, with greater care than would be the case if
he used the pure blood kept fluid by a lower tem-
perature. As to the amount of blood to be drawn,
it depends, of course, on what conditions exist in
the patient. Probably twelve ounces had better be
drawn at once, and provision made for an equal
supply from another source if the injection of the
first quantity is without effect. As soon as the
requisite amount has been obtained, a pledget of
lint should be placed over the wound and com-
pression applied by means of a bandage.
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55
Ozone by a New Process. — An apparatus for
manufacturing Ozone, patented by Dr. Loew, is
mentioned in the "Journal of the Franklin Institute.
Sometime since, Dr. Loew observed that cold air,
blown through a flame, is in part converted into
Ozone, and his apparatus is constructed with a view
to turn this observation to practical account. It
consists of a number of Bunsen burners set up in a
row, with an equal number of horizontal tubes at
some distance above the burners. The cold air is
blown through the tubes against the flames, and is
then collected, in the shape of Ozone, by a number
of funnels, placed on the oposite side of the flames.
The Ozone is, to some extent, contaminated by
Acetylin and Nitrous Acid.— Pop. Science Monthly.
Having now obtained the blood, defibrinated and
filtered it, the next step is to fill the syringe and
inject the blood. If the barrel of the syringe is of
glass, it will be easy to detect any air bubbles. If
the instrument is of hard rubber, it will be best to
act as though there were air bubbles in it and pro-
ceed to expel them. This is clone by pointing the
nozzle of the syringe directly upward. If bubbles
are present they will rise to the highest surface of.
the fluid, which will be just under the tube. The
piston should now be gently pressed till all the air
has been expelled and the fluid begins to flow with-
out bubbling. The remainder of the operation con-
sists in inserting the point of the syringe into the
valvular opening in the vein of the patient, drawing
the walls of the vein well over the tube, and secur-
ing it in position, if necessary by the ligature, and
then injecting slowly. The syringe may be with-
drawn and repeatedly filled should its capacity not
be sufficient to throw in the requisite amount of
blood by one filling. As soon as the operation is
over, bind up the arm of the patient as usual after
bleeding. This constitutes the operation of trans-
fusion. There are many other ways of performing
it, and innumerable instruments have been devised
in order to facilitate the operation, but the method
given above is as good as any and much the sim-
plest. The dangers of the operation lie in the ad-
mission of air into the circulation ; in the creation
of an embolus or the introduction of a coagulum
into the vein ; and, lastly, in the production of
phlebitis at the point of operation. Either of these
three occurrences would, in all probability, be a
fatal mishap. The first is avoided by selecting a
proper place for operation, by completely expelling
all air-bubbles from the syringe before injection, and
by drawing the vein well over the nozzle of the syr-
inge. The arteries may be used, instead of the
veins, for transfusion, as affording greater safety in
this particular, injecting, of course, in the direction
of the arterial flow. The second danger, the intro-
duction of a clot into the circulation, is obviated by
using defibrinated blood. The third and last danger,
phlebitis, may be considered as purely imaginary, at
least I have been unable to find a recorded case of
such a result from the operation. Practically, there
is very little likelihood that any of these dangers
will occur, if ordinary care is used. They are
possibilities rather than probabilities.
I have not attempted in this paper to give a
complete survey of the subject, but merely to indi-
cate some points that will repay investigation ; and
this is my apology, if apology is needed, for omitting
much that is interesting and important.
i£orre$pon6ence.
In the summer of 187 1 the writer of the following
letter, a gentleman distinguished in art and litera-
ture, was advised to visit Minnesota, hoping that
under the influence of its dry and bracing climate
his life might be prolonged. The change in his
health was so decided that, at our request, he has
kindly furnished us a report of his case. In the
next number of our journal we hope to give an arti-
cle from a distinguished scientist of Minnesota on
the climate of that State and the new territories
which are now being opened in the far West :
Winona, Minn., Feb. 24, 1873.
Dear Dr. : — I wish 1 could give you a thorough
report of the effect of Minnesota climate upon pul-
monary disease ; but that is impossible, as there
areno statistics available that would give anything
like an adequate view of the subject. And statistics
in such matters will be always, I suppose, to a certain
degree, untrustworthy. So many cases come here
that are noticlearly defined, so many are hidden by
the natural tendency to deny an affection of the
lungs, so many incipient cases are lost sight of in
apparent health among those who take up resi-
dence here, and so many invalids make a partial
trial of the State, remaining a few weeks or months,
and then returning East to die, that the compilation
of a fair estimate would be a matter of long obser-
vation and patient labor. The larger portion of in-
valids go to St. Paul and Minneapolis (though they
are settled everywhere), and I have not yet visited
those cities, having spent a year and a half here in
Winona, in the southern part of the State.
A resume of my own experience may, however,
be interesting to you, as you know something of my
constitution and habit. This will show you the
effect of th# climate on my own case, which, I
think, represents a large proportion of phthisical
cases. I will remind you of my condition prior to
my departure from New York. Age, 35. Occupa-
tion, artist. Have lost two brothers by consump-
tion. Not of strong constitution, and always sub-
ject to weakness of stomach and sick headaches.
Had been troubled with catarrh and mild bronchitis
for a long time, and latterly cough and occasionally
bloody sputa. July 7th, 1871, in New York, had a
considerable hemorrhage, and within the next three
days two more : the last of which was profuse and
reduced me to my bed, which I was unable to leave
for nearly three weeks. Got out of doors in about
a month, and began to gain slowly. Weighed 104,
normal weight 125. Left New York September 9th,
and journeyed slowly to Minnesota, arriving at Wi-
nona on the 20th. At first I felt very languid and
coughed badly, but forced myself to be in the open
air a great deal. I soon got a sharp appetite, taking
long walks and climbing bluffs. Still my breathing
was very short, and pulse rapid on such exertion.
On horseback I could trot only a few rods for lack
of breath. But in October I gained rapidly, though
I think I rather over-did my exercise. First No-
vember, weighed 120. At this time it was dry and
dusty, and I had an irritating dry cough and in-
flammation of the nasal passages. Very little ex-
pectoration. Night-sweats gradually diminishing.
Was examined by a physician, who reported some
infiltration at the upper part of the left lung and a
moderate sized cavity. He thought the disease was
56
The Medical Union.
nearly inactive. Improvement continued up to Feb-
ruary, 1872, when I made a jqurney to Faribault,
took a severe cold, which finally settled in the
bronchi, and gave me expectoration, at first blood-
tinged, which lasted through the spring and sum-
mer. All through the winter, however, I was ac-
tive in exercise, riding horseback and walking, and
was able to accomplish something in- the way of
work. My weight fell in February to 115. Had
severe catarrh and some bleeding at the nose. The
winter was very trying, the changes of temperature
excessive. I noted one change of sixty degrees in
thirty-one hours. These changes, however, did not
embrace any high degree of temperature, their
scope being generally below the freezing point. I
came out in the spring, notwithstanding my draw-
backs, with a good degree of vigor, and no worse,
I suppose, in the lungs. I could ride on horseback
eight or ten miles without too much fatigue. Ap-
petite became feeble and physical exercise declined
as the hot weather came on. In July went to Mil-
waukee and Chicago, and did some work, there.
Reached Winona again on the 20th September,
1872, feeling pretty well, but looking poorly and
weight reduced to 109. Had careful examination
of the lungs, and the doctor reported' little change,
but what there was, for the better. I immediately
began out-door life, with what strength I could
muster. Went hunting every day (wild ducks are
abundant here), but the gun was dreadful heavy
for the first week or so. Change for the better
came gradually, indicated by increased weight and
diminished expectoration, November 1st, began
to take cod-liver oil, and have taken it regularly
all winter. I am disinclined to eat fat food, and I
think the oil has benefited me very much. Three
weeks after beginning it my expectoration had de-
clined one-half, and I have now none worth men-
tioning. Weight, for the last two ^nonths, 119.
Health and strength better than at any time in the
last three years. Yesterday my physician made a
thorough exploration of the chest, and reported me
doing ' ' better than ever. " The cavity is cicatrized
and scarcely discernible. I have some cough in the
morning. Can do as much work (provided part of
it is in the open air) as I ever could.
It is worth remark, in considering this case, that
the two winters passed here have been exceptionally
severe, though perhaps not worse than elsewhere.
The deaths by freezing recently reported in the
western part of the State were mostly resultant of
the exposure incident to frontier life. I cannot see
that the extreme cold has had any direct effect upon
my disease, though of course it somewhat limits out-
of-door exercise. When my walks have been ex-
tended with the mercury below zero, I have worn
the wire-gauze respirator you recommended ; but I
think it should be used as sparingly as possible, as
the vapor seems to soften the nasal passages, and
render them over-sensitive to cold. There have
been but two days this winter when I have felt the
necessity of remaining in-doors, and that from wind
rather than the degree of temperature. There is
possibly some sedative effect from such prolonged
cold (my pulse averages but little over 60), and per-
haps some depression of spirits and nervous energy.
I think this case shows that Minnesota is the
proper climate for a certain class of consumptive
invalids. But it should not be forgotten that
though I was much reduced (so that my physician
was doubtful about my getting up at all), I had, on
reaching Minnesota, every advantage. I believe I
came at the best possible time — the early fall. It is
very hot here in summer, and almost as damp as in
New York. The fall is delightful, and there is no
rain from November to April. A large proportion
of the days are clear and sunny. Further, I have
had immunity from business or pecuniary care dur-
. ing my sojourn here. I have had the most careful
and cheerful nursing, and I suppose it is patent to
the profession that any consumptive patient, how-
ever well he may feel, needs watching. 1 have also
had the advantage (which is not an advantage in
every case, perhaps) of knowing, from true med-
ical friends, just what I had to contend with from
the beginning. Notwithstanding these helps, it
seems clear to me that the gain I have made is
largely attributable to change of climate. 1 am of
the opinion that had I remained in New York, un-
der the most favorable circumstances, I should soon
have sunk. The air here seems to dispose one to
exercise, and an immediate and constant effect is felt
upon the digestive organs. I have had no sick
headache at all, and my stomach seems to have out-
grown its weakness. One easily gets an active
bodily habit here, and that is so valuable where the
digestive organs are feeble. I think there can be
no doubt that this is the way the climate acts upon
any disease — through improving assimilation.
Confident as I am of the climatic aid I have ex-
perienced here, I have no doubt that many con-
sumptives are wrongly advised to come. There are
many things to be considered. Among these are
the climate of the patient's previous residence,
whether he does best in cold or warm weather,
whether he can make himself contented remote from
the attractions of the East, the condition of the
digestive organs, the season when the change is
made, etc. ; but more particularly, the amount of
vitality remaining and the character of the disease,
whether acute or chronic. I am hearing now and
then of consumptives in various parts of the State,
who appear not only to get no good from the
change they have made, but to get absolute harm.
Of course cases of sudden decline and death are
more likely to be published and gain prominence
than the many instances of less defined disease, lost
sight of in growing health, and there seems to be
now a re-acting tendency among resident physicians
against the climate as curative of consumption. I
think this re-action is temporary, and that it is the
result of the influx of patients far advanced in dis-
ease or affected with disease of an acute character.
These cases, where the course of decay is accel-
erated, and the patient dies, are sure to be brought
to the notice of physicians, while many of the mild
cases never come under careful professional obser-
vation at all. While physicians are wisely cautious,
and qualify their statements carefully, the popular
opinion is that the " cures " of the climate are legion.
Non-professional advice is properly open to sus-
picion ; but I shall not refrain from saying that if I
were a medical man, outside circumstances being
favorable, I would certainly send any consumptive
patient here, whose disease was of a positive chronic
type, and who had still a reasonable amount of
breathing surface.
In regard to the relative claims of different parts
of the State I am not much informed. Not many
invalids are sent to this city. Still, there are here
The Medical Union.
V
many remarkable cases of arrested disease, and
healthy men are often pointed out to me, as having
come to Minnesota with consumption. Winona lies
in the valley of the Mississippi ; and, perhaps, in
the summer it would be better for the invalid to go
to the high prairie land (600 feet above the river),
where it is cooler and, probably, a little dryer. Good
accommodations are to be had only in the towns ;
farmhouses here are mostly barren of all comforts.
I like Winona particularly for the dry soil. It is a
loose, warm gravel, which takes up the moisture
like magic, and makes it always good walking, ex-
cepting for a few days in the Spring when the snow
melts. I should have mentioned that there is less
snow here than in like latitudes of the East, and
that it rarely thaws much until Spring.
I might send you many cases of remarkable cures,
but I could get the complete history of only few of
them ; and it is evident that little could be proved
without an approximate record of all. Cases have
little value, I apprehend, unless they are made up
from prolonged professional observation, and very
few such are accessible to me. What result a care-
ful sifting down of the great number of instances of
alleged cures would give I cannot tell, but I am
confident it would be favorable to this climate re-
garding the class of disease I have indicated. Two
interesting cases* of tuberculosis are briefly given in
the recent report of the State Board of Health. The
parties are personally known to me, and their con-
dition confirms the view I have presented to you.
I think I may conclude by suggesting that patients
should not allow themselves to be discouraged by
the lack of comforts or luxuries sometimes felt in
this comparatively new country. There are, I sup-
pose, some conditions of invalidism where there
maybe too much comfort. Out-door activity seems,
to me, the great desideratum, and fresh vitality will
soon compensate for any luxuries abandoned. The
new-comer may, likely enough, think he is declining,
when he is really gaining. Catarrh is very preva-
lent here, and upon arrival I think a cough is likely
to become more troublesome ; but if the patient can
endure these and has strength to get about, he will
soon begin to be prompt at dinner, and feel encour-
aged. And when disposed to help himself, he will
get all the outside encouragement possible, for there
are no kinder or more sympathetic people than those
here ; many of whom have come as invalids, and all
of whom are directly or indirectly interested.
C. A.
Scientific ifileanings.
A VERY good liquid glue is obtained by dissolving
glue in Nitric Ether. It is more tenacious than
that made with hot water, and may be rendered
almost damp-proof by introducing a few pieces ol
Caoutchouc, and letting the solution stand a few
days, with frequent stirring. As the Ether will dis-
solve only a fixed amount of glue, the mixture can-
not be made too thick.
Testing of Urine for Biliary Acids.— M.
Strasburg {Repertoire de Pharmacie) uses the fol-
lowing method, which seems elegant, safe and
easy. 1. A bit of sugar is dissolved in the urine.
2. A bit of filtering paper dipped in the urine and
dried. 3. When the paper is dry, one or two drops
pf Sulphuric Acid are put upon the paper, If the
urine contain Biliary Acids, the paper assumes a
bright violet color, on being examined with a strong
light.
Tincture of the Chloride of Iron for
Corns. — Dr. C. Barber states {Lyon Mtdicale)
that he has cured three cases of corns, on the toes,
by the application of a drop of the Tincture of the
Chloride of Iron applied to the corns, night and
morning. This application was continued for
fifteen days in one case, when the corns, from which
the patient had suffered thirty or forty years, were
entirely destroyed, and pressure upon the part gave
not the least uneasiness. — Med. News.
Fatty Liver During Lactation. — As the
result of a series of investigations carried on in the
physiological laboratory of the College of France,
M. Sinety has found, that in females, during lacta-
tion, the liver is always in a fatty condition. The
fat is, however, in this state, deposited in the deep-
seated portions of the organ, the corpuscles being
ranged around the central vein, and extending
thence, sometimes to the middle, and, though rarely,
to the periphery. This localization of the fat has
been found to be more limited in women and in the
bitch than in the herbicord ; but in all, the fat has
been abundant at the centre, and wanting or rare at
the periphery. This disposition is precisely the
reverse of that which obtains in fatty degeneration
or infiltration of the liver, and in artificial fattening,
where the process goes on from the periphery to-
wards the centre of the lobule.
Juniper Tar Soap. — The Druggists' Circtdai
gives the following, as the formula for u Juniper
Tar Soap : " R. Oil of Juniper, fzj ; Soft Soap, fzj ;
Alcohol, fzj. The same journal answers a corres-
pondent who asks if there is any varnish which
will protect surgical instruments from rust, as fol-
lows : " There is, but we do not recommend it for
such a purpose, though it is very useful to protect
steel under other circumstances. Here it is : melt
common resin, with a little Gallipoli Oil, and Spirits
of Turpentine, in proportions adapted to the partic-
ular case. The varnish should adhere firmly,
should not chip, and yet, be easily removed. We
have recently seen a mixture of Carbolic Acid and
Olive Oil recommended in an English paper, but
Paraffine dissolved in Benzoine is said to be better.
We do not think that the simple Mercurial Ointment
can be improved upon for delicate instruments.
On the Gynaecological Employment of
Transplantation of Small Portions of
Skin, for the Healing of Indolent Ulcers. —
Dr. Thomas Beigel {Wien. Med. Presse, xxii. 23,
1872) records two cases in which he had tried
transplantation of skin successfully.
Case I. A woman, aged 38, had a large indolent
ulcer of the vagina and posterior lip of the uterus,
with profuse secretion. After fruitless efforts at
healing it by caustic agents, transplantation of por-
tions from the opposite healthy side of the vagina
was tried, the pieces being kept in position by a
plug of cotton wool, steeped in glycerine. The ul-
cer healed over perfectly in six weeks.
Case II A servant, aged 25, had a large ulcer,
two inches in diameter, on the posterior vaginal
wall. Various modes of treatment were employed
without avail. Transplantation of four pieces of
skin from the arm, was resorted to, and the ulcer
was perfectly healed over in eight weeks' time.
,8
The Medical Union.
Case of Extra Uterine Pregnancy (by
Dr. Soy re j Le Mouvement Medicale.) — The case
was seen by M. M. Chautreuil and Sueniot.
It was thought, on examination, that she had
a fibroid tumor of the uterus, or else that dropsy
of the amnion existed. The possibility of the ex-
istence of a twin pregnancy was also, for a time
at least thought of. The patient was sent to the
Hopital des Cliniques. The diagnosis remained
uncertain. For the purpose of relieving the dropsy
of the amnion, a stylet was introduced, to perforate
the membranes. Perforation of the uterus was the
sole result of this operation. The woman died, and
it was found at the autopsy — i, that the tumor con-
sisted of the placenta and large clots of blood ; 2,
that the case was one of extra-uterine (abdominal)
pregnancy; 3, that hydramnios really existed. M. M.
Chautreuil and Sueniot insisted on the difficulties of
the diagnosis. In this case the laminated blood-
clots, surrounding the placenta, attached to the
posterior surface of the uterus, imparted to the
touch the sensation of a fibrous growth. M.
Lionville has recently seen a case of extra-uterine
pregnancy at the' Hotel Dieu, in which, the blood-
clots were also quite numerous.
How to Arrest the Development of Boils,
Felons, &c. — Dr. Simon, of Lorraine, in the
Scalpel, of Belgium, declares this method infallible :
— As soon as you perceive on any part of the surface
the characteristic redness of varying form and size,
and with a culminating point in the centre which
soon passes from red to white, put in a saucer a
thimbleful of camphorated alcohol, dip the palmar
surface of the three middle fingers in the liquid and
rub the inflamed surface, especially the central por-
tion. Repeat this proceeding eight or ten times,
each time occupying about half a minute. Then
allow the surface to become quite dry and apply a
thin coating of camphorated olive oil. A boil sel-
dom requires more than four such applications, and
often a single one is enough to cause it to dry
up and disappear. When several applications are
needed they should be made at intervals, say morn-
ing, midday and evening. The same treatment is
equally successful in felons and injuries of the tips
of the fingers. As soon as pain and redness are
perceived in the finger, it should be soaked for ten
minutes in a small glassful of camphorated alcohol,
then well dried and afterwards soaked in another
glassful of camphorated olive oil. The relief is im-
mediate, and three applications are generally suffi-
cient to effect a cure.
[We hope Dr. S. may have a crop of felons on
his own person and try his own remedy, but we
advise no one else to depend on it. — J. C. M.]
Importance of Hospital Attendance. —
(From Dr. Sewell's Presidential Address at the Can-
ada Medical Association. ) — I believe the student can-
not too soon commence his attendance at the hospital,
and although his medical education may not be
sufficiently advanced to enable him to profit by his
attendance to its fullest extent, still, if he is observ-
ant he will pick up much which will be invaluable
to him hereafter, and he will learn much which
will render the lectures he will receive later on in
the college far more intelligible, and, therefore, far
more profitable than they would otherwise be. To
the same effect is the language of the great Trous-
seau. Addressing his class, he says, " Clinical in-
r.truction should not be deferred till near the end of
the student's curriculum. From the day on which
a young man determines to be a physician he
ought to attend the hospital. It is essential to
see — to always be seeing — sick persons. The hetero-
geneous materials, though amassed without order,
nevertheless, excellent materials. They may
ar
be for the present useless, but at the later time he
will find them stored in the treasure-house of his
memory." And they will become of incalculable
service to him.
Galvano-Acupuncture for Aortic Aneur-
ism.— Professor E. De Renzi reports a case thus
treated, and reviews the records of other cases. In
his own case the battery used was one of twenty-one
elements ; the zinc plates four to five centimetres
broad, by eight long, immersed about half their
length. The index stood at sixty when the circuit
was open, at twenty when it was closed. Six needles
were inserted, and each pole was attached for five
minutes to each needle, so that the whole operation
lasted an hour. On the seventh day the man died
of rupture of the sac. An autopsy showed no trace
of any clot near the points where the needles had
entered, but some evidence of inflammation. The
conclusions to which Prof. De Renzi is led, by his
review of Ciniselli's cases and others, are — 1. That
no case is known of a complete and permanent cure
of aortic aneurism by galvano-acupuncture ; 2. That
the cases of apparent cure are more readily ex-
plained by the irregular course of the disease and
the effects of quiet and good hygienic influences;
3. That the operation is harmless in itself, but may
be the indirect cause of mischief by inducing
changes in the walls of the sac, rendering them
more liable to burst. — Nuova Liguria Medica.
Talmudic Gleanings. — In the December num-
ber of The Scattered Nation — a journal devoted to
the reformation of the Jewish race — are a number
of " Talmudic Gleanings," from which the following
are extracted. Their biting character serves to
show the priestly race of yore in strong antagonism
to our art :
" 14. A doctor that heals for nothing, his cure is
worth nothing. — Bava Kama, fol. 85, 1.
" 15. Most donkey-drivers are wicked, most
camel-drivers are worthy, most sailors are pious, but
the best of doctors are for hell. — Kedushin, fol. 82,
I. — Note. — A doctor, says a certain writer, has the
advantage over the Angel of Death. The latter kills
gratis, but the former is paid for it.
" 16. Seven have no portion in the world to come
—the legal writer, the scribe, the best of doctors,
Qtc.—Avoth Drb. Mathau, c. 36.
" 17. When a patient says, I am in need of (cer-
tain food), and the doctor says he is not in need of
it, the patient is rather to be listened to ; for (Prow
xiv. 10) the heart knoweth its own bitterness. —
Yana, fol. 83, a. c. 1.
"18. If there be no Israelitish doctor in a city,
but there are in it a Samaritan doctor and a Gentile
doctor, the latter may circumcise (a Jewish child),
but not the former. — Avoda Zarah, fol. 2. 26, c."
An Astonished Allopath.— M. Messenger
Bradly, of Manchester, in a letter to the British
Medical Journal, says : " Happy are they who can
hear their detractors and can put them to mending.
I have recently learnt a lesson from the Homoeopaths,
which is worth knowing. I lately had a patient of
a highly excitable nature, who suffered from severe
The Medical Union ,
59
attacks of neuralgia of the chest walls. I run
through all the orthodox treatment Jfor neuralgia
from the hyssop on the wall in the shape of Quinine,
even to the cedars of Lebanon, or blisters and Ar-
senic, to eye soreness. Nothing, however, did him
any good. When the lethargy caused by a narcotic
drug passed away, the pain was found to be un-
abated. One day I missed him, but the next he
returned, to tell me he was cured, and by a Homoeo-
path. He brought the magic secret with him,
which was simply a couple of drops of the Mother
Tincture of Phosphorus in a little Glycerine. There
was no mistake about it, he said. He was in agony ;
he swallowed the draught, and in two minutes
was well. Since then my patient, who had to go to
the Homoeopaths to be cured, never travels without a
small bottle of the Mother Tincture of Phosphorus.
I have since used the drug whenever I met with
what I thought a suitable case, and have every
reason to be satisfied with it. It will not cure every
patient, but, when the neuralgia is^accompanied by
much nervous waste, as is often the case in the ner-
vous and sanguineo-nervous temperament, then it
rarely fails to put an end to the paroxysm. Rom-
berg calls neuralgia the cry of the hungry nerve for
blood ; it would, perhaps, be more correct to say,
it is the demand for its special food, which is
Phosphorus contained in the blood."
Acute Mania Treated by the Wet-Pack.—
The following case is reported by Dr. Shephard, of
Colney-Hatch Asylum: A lady, 19 years of age, who
had recently recovered from scarlet fever, was attacked
by acute mania. Previous to the attack of scarlet
fever, she had always enjoyed good health. Her
family relations were happy, and there was no here-
ditary tendency to insanity. I was called on the
second day of the attack, as the local practitioners
had been baffled in their attempts to meet the emer-
gencies of the case. As I ascended the . staircase,
I heard vehement declamations and shouts,' associated
with as obscene language as the nastiest mind could
desire. The bed-room was strewn withjdifferent
articles; one of the windows had several panes
broken ; the mirror was also broken ; the whole
place was a Babel of confusion. Wild and flushed,
the central figure, this young, mad and infurious
lady, with disheveled hair, torn night dress, and
exposed bosom, sat up in the middle of the bed.
As I approached her she sprang out of bed, and
ordered me to leave the room instantly. With a
menacing aspect, spitting at me, she stood with
dilated nostrils and heaving breast, fierce as a lion-
ess at bay, the incarnation of ungovernable passion.
After a half hour's exertion, we succeeded in pack-
ing her in wet sheets. Five minutes afterwards, she
asked for water, which was eagerly gulped down. It
was the first, either of liquids or solids, that she had
taken for two days. In ten minutes, our. young
lioness was asleep, and breathing calmly. At the
end of two hours, she was unpacked, rubbed dry,
and put in clean linen. She refused nourishment,
but fell asleep quickly, and slept quietly for five
hours. Afterwards she took a glass of pale ale,
some milk, and beef tea, with two eggs beaten into
it, and seemed as calm as she had ever been in her
life. Nourishment was given her at short intervals,
and she had no bad symptoms afterwards. Three
months afterwards she was married. She has borne
children, and the puerperal state has been free from
all complications.
Functional Dyspepsia, Anemia, and Chlo-
rosis.— Dr. Brown-Sequard, in the Archives of
Scientific and Practical Medicine, gives the follow-
ing hygienic treatment of these diseases: " It con-
sists in giving but very little of solid or fluid food,
or any kind of drink at a time, and to give these
things at regular intervals of from ten to twenty or
thirty minutes. All sorts of food may be taken in
that way, but during the short period when such a trial
is made, it is obvious that the fancies of the patient
are to be laid aside, and that nourishing food, such
as roasted or broiled meat, and especially beef and
mutton, eggs, well-baked bread, and milk, with but-
ter and cheese, and a very moderate quantity of veg-
etables and fruit, ought to constitute the dietary of
the patients we try to relieve. This plan should be
pursued two or three weeks, after which the patient
should gradually return to the ordinary system of
eating three times a day." * * " My experience
with the patients on whom I have tried the plan of
feeding above mentioned, shows that the amount
of solid food required by an adult is nearly always
as follows: From 12 to 18 oz. of cooked meat, and
from 18 to 24 oz. of bread. As regards the amount
of fluids I have allowed, it has always been notably
less than the amount indicated by Dr. Dalton (3
pints)." * * " The only essential points are that
the amount of food taken every 10, 15, 20, or 30
minutes be very small (from two to four mouthfuls),
and that the quantity of solid food in a day be from
32 to 40 oz., or a little less where, instead of water,
the patient drinks beef-tea or milk." * *"I will
simply say that the facts I have observed agree with
the view that we are naturally organized, like most,
if not all, animals, to eat very frequently, and not,
as we do, two, three, or four times a day. It seems
certain, from the facts I have observed, that func-
tional dyspepsia, when once it has begun (never
mind by what cause), is kept up and increased by
distension of the walls of the stomach." * * "In
anasmia and chlorosis, not complicated with dyspep-
sia, the advantage of this plan lies in the rapidity of
formation of blood from the notably increased
amount of food that the patient can digest." A
very interesting case is cited, illustrative of this
treatment, in which the number of meals in a day
was changed from three to sixty or more with im-
mediate relief.
Ihe Jflebical Union iCUnic*
Oleum Sinapis nigri (Sulpho-cyanallyl), in Vari-
ola.— Case i. — Mr. S. was seen February 4th, in
consultation with the attending physician, by my
partner, Dr. Ferris, upon a question of diagnosis.
He found the patient in the first stage of a variolous
eruption, Avith loss of speech, anxious look and
subsultus tendinum. Gave Atropine 2d.
On the following evening I was called in con-
sultation to the case, and found the patient still
with the above symptoms except that the former
subsultus had given place to actual clonic spasms.
There were also present, sclerotic congestion, con-
tractions of the iris, a hot and swollen condition
of the head and face, together with a muttering
delirium. Upon a closer examination, I noticed
a regularly progressive eruption upon the trunk
and upper extremities, while that on the face had
evidently become arrested since the first or second
day of its appearance, yet without any signs of
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an actual repercussion. The pulse was full, tense,
and slow, like that we often find in cases of cere-
bral apoplexy. There was total suppression of the
urine, and, what was even more noticeable, an
equal suppression of the salivary secretion with ex-
cessive dryness of the whole buccal cavity, and of
the mucus surfaces of the nose and eyes. I pre-
scribed Oleum Sinapis nigri'2d dec.
Upon inquiry next morning, I learned that an
hour after the administration of the above remedy,
the patient passed water freely, followed by a still
more copious discharge towards morning. The
nervous symptoms had ceased, the delirium assum-
ing a more loquacious character, with hallucinations
of the personation of Deity. The delirium ceased
in about twelve hours, and the patient, under the
continued and sole use of this remedy (an allyll
compound), made a rapid recovery. I regret that
the promised report of this case in full has not
yet been received from the attending physician.
Case ii. — Miss S., aet. 20, was first seen by
me during the variolous fever, and afterwards
treated by Dr. Ferris. During the prodromous
stage there was violent epistaxis, high fever and
severe general myalgia. The efflorescence was ex-
tensive, with ail the indications of a confluent
course.
The epistaxis was controlled by Hamamelis, and
all the subsequent symptoms by Oleum Sinapis
nigri, 2d dec. Upon the action of the sulpho-
cyanallyl was supposed to depend this favorable
result. The case ran a kindly yielding course, ter-
minating in the confluent variety, but without
either a noticeable secondary fever or sequellae of
any kind. Here too it is worth mentioning that
with the administration of the remedy there oc-
curred a salivary crisis, after which all the cutane-
ous symptoms were ameliorated.
F. A. Rockwith, M. D.
Eczema treated 'with Concentrated Petroleum. — A
gentleman, aged fifty-five years, naturally strong
and healthy, applied for relief for a severe form of
eczema, which had come on without any apparent
cause and spread over the lower limbs. The erup-
tion was at all times exceedingly uncomfortable,
but at night the itching was often so severe as to
prevent sleep. Persistent medical treatment had
been tried for a year, during which various remedies
had been used, but with only temporary and par-
tial relief. A few applications of the concentrated
Petroleum entirely removed the trouble. Two
months have elapsed, and there is no indication of
the return of the eruption.
Egbert Guernsey, M. D.
Terebinth in Hemorrhage.— A young man,
twenty-four years of age, nervo-sanguineous tem-
perament, of good health up to the time of an at-
tack of dysentery, applied for relief for a severe
form of hemorrhage from the bowels which had
troubled him for over a year. The hemorrhage came
on about a month after his apparent recovery from
the dysentery. A speculum examination revealed a
perfectly healthy rectum. At times there would be
a large discharge of mucus, followed by a severe
hemorrhage of bright red blood ; again a compara-
tively healthy passage would be followed by the
blood, the feces showing no traces of it ; and
sometimes the hemorrhage would come on with great
violence, producing extreme exhaustion, neither
mucus nor feces being present. He had been very
careful with his food and the attacks were attended
with but little pain. He had been under the
care of one of the best homoeopathic physicians in
the city, but had experienced no relief. Under the
influence of terebinth 1st, he made a speedy and
complete recovery. Four months have elapsed,
with no return of the hemorrhage.
Case ii. — Mr. B., a young man of weak and
scrofulous constitution, called on me with a severe
form of hemorrhage, similar to the above. He had
been troubled with it for nearly two years, and had
only obtained from various forms of medication tem-
porary relief. Under the influence of terebinth he
made a rapid recovery. For two months he has
had no return, is taking cod-liver oil, and is able to
attend to business. Egbert Guernsey.
Mania. — Miss
aet. 23, nervous temperament.
Had always had good health, except that her friends
thought she had not at times her usual mental bal-
ance. Just previous to her present illness had been at-
tending University, where she studied very hard
and was regarded as the most brilliant in her class.
Three weeks before I saw her, she was attacked
with inflammatory rheumatism ; confining itself,
however, to her right foot and left hand. During
that time she was treated homceopathically, but no
change was observed in her symptoms, except that
she grew more and more nervous ; and during the
last seven days preceding my visit to her, had only
slept three hours. I was hastily summoned early
in the morning and found her insane. She mani-
fested the symptoms usual in such cases, varying
from mild to the most violent. For a few days she
would take neither food nor drink, and again dur-
ing the coldest weather would only have a cotton
sheet for a covering. If opposed in the least de-
gree, would become frenzied. Remedies could only
be given her when she would take drink of some
kind and then only by deception. All the senses
were acute in the highest degree. Those whom
she most loved when well, were now the most re-
pugnant to her.
The remedies usually given for such conditions,
viz: Bell., Stram., Hyos., Opium, Gels., &c, seemed
ineffectual in quieting her or giving any relief. I
then gave Kali Bromatum, ten (10) grains in sweet-
ened water every two hours. She soon became
more quiet and slept some. I continued this when
she was awake and at longer intervals between the
doses for about one week, but without further per-
ceptible improvement until it had developed the
eruption similar to Acne, peculiar to the Bromide.
I returned to Bell, and Stram., and gave her Chloral
to be taken at ten o'clock at night, dissolved in
syrup, in the proportion of five grains to a tea-spoon-
ful. She took two tea-spoonsful and slept quietly near-
ly all night, and seemed much better. She improved
very rapidly under this treatment. In a few days
she was able to sleep most of the night without the
Chloral, and needed only one attendant. Under the
use of the Hypophosphite of Lime and the Citrate
of Iron and Strychnia and Phosphoric Acid she
soon recovered her full mental faculties and general
health, except the rheumatism in her foot, which
slowly recovered. The mania lasted about four
weeks. J. N. Anderson, M. D.,
Rochester, N.Y.
The Medical union.
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The Medical Union
A MONTHLY JOURNAL
Of Medicine, Surgery, and the Collateral Sciences.
Editors :
EGBERT GUERNSEY, M.D. CHARLES E. BLUMENTHAL, M.D.LL.D.
JOHN C. MINOR, M.D. ALBERT E. SUMNER, M.D.
Published on the First of each Month, by
C. T. HURLBURT, 898 Broadway, New York.
NEW YORK, MARCH, 1873.
" A regular medical education furnishes the only presumptive
evidence of professional abilities and acquirements, and ought to be
tlie only acknowledged right of an individual to the exercise and
honors of his profession.'" Code of Medical Ethics, Amer. Med
Ass., Art. iv, Sec. i.
The medical fraternity of Brooklyn may justly
claim the honor of establishing the noblest monu-
ments to the memory of Hahnemann yet erected.
On the 13th of last month, the Bishop of Long
Island dedicated a hospital for the accommodation of
one hundred patients, that would be creditable to
any school or city. It is fitted with all of the
modern hospital appliances and is already receiving
patients. It is beautifully situated, and the trus-
tees own a sufficient amount of ground to enable
them to erect buildings for the reception of five
hundred patients. The hospital is the result of
long-continued and earnest work on the part of a
few physicians and laymen, and creditable to both
alike.
It seems singular that the only opposition to the
establishment of this institution came from some of
the homoeopathic physicians of the city. If the
members of the old school were opposed to it, they
made no active opposition, while the lay members
of that school, in many instances opened their
purses unasked, and assisted in every way to place
the institution upon a substantial basis. Had the
same feeling existed among all of the members of
the school in the city, the result might have been
still more creditable.
Brooklyn has in addition to the hospital a lying-
in asylum and four dispensaries. The asylum is
soon to be placed in a fine building of its own, and
together with its nursery and school for nurses, will
rank among the most successful institutions of the
city. Twenty new beds were placed last month in
the wards, and every effort is being made by the lay
members and physicians to add to its usefulness.
This institution is managed by a board of forty la-
dies who are untiring in the work given them to
do, and the success which has attended their efforts
is conclusivejevidence that institutions of this class
should invariably be placed in their hands.
The dispensaries of the city are models in their
way, and are unequaled in the country by any
school cf practice. The original design was to
make them schools for physicians and a benefit to
the poor. In carrying out this plan the physicians
were appointed to special departments and each
department provided with all of the new books and
instruments. It is safe to say that there is not an
institution of the kind to be found that is as well
equipped as the Brooklyn dispensary.
THE FUTURE OF MEDICINE.
Dr. Dunster, in an anniversary address before
the New York Academy of Medicine, seems some-
what dissatisfied with the progress in the medical
world of therapeutics and looks to the future for a
clearer insight into the action of remedies. "To
isolate morbific principles," he says, "and to
ascertain the exact nature of all disease-producing
agents, and to learn accurately the initial changes
wrought by them, are clearly the preparatory steps
to an acquaintance with the laws of the cure of
disease. But even this knowledge is not impossible ;
there can be no doubt that sooner or later the
laws underlying the therapeutic action of remedies
will be reached ; that there are such laws it seems
to me is indisputable, for law which is not a self-
acting agent, but only the expression of God's will,
in the workings of the universe, is present and
acting everywhere and under all circumstances ;
and as in the past and the present, so will it be in
the future that the impediments in searching out
these laws will be found to lie less in the intrinsic
difficulties of our subject than in the erroneous and
illogical methods of conducting investigation into
them. The future, then, is full of promise ; and we
may well content ourselves with the reflection that
as centuries upon centuries have been spent in
bringing about our present advanced position, so
hereafter each successive decade will give a steadily
increasing development.
"I plead for the entire abandonment of all faulty
methods of investigation and reasoning, and for a
still firmer alliance with those, which in other quar-
ters have produced such solid and brilliant acquisi-
tions ; for a diminishing reliance upon the ' blind
gropings of empiricism,' and a still closer affiliation
with the whole temper of modern science ; for the
exclusion of all fallacies, and the adoption of every
safeguard, which can indicate a wrong direction in
our labors ; for the final displacement of self in the
interpretation of the phenomena of life, and the con-
centration of all our powers in searching out and
verifying the laws which govern the relation and
succession of those phenomena ; in a word, I plead
for the incorporation into all our studies and all our
work of the logic of medicine."
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And to this, we most heartily say amen. But,
has not a law of therapeutics already been dis-
covered, which leads us away from the " blind
gropings of empiricism " on to the sure and firm
basis of scientific investigation, founded upon
thoroughly proved and firmly established facts '
Does not the law of similia and the proving of
drugs on the healthy organism, give us a clue
out of the tangled maze, which has so long
bewildered the medical world, and exalt therapeutics
to a rank among the sciences ? We are convinced
if the learned doctor and those, who like him are
dissatisfied with the spirit and investigations of their
own school in the past, would carefully investigate
the law of similia in the light of their own daily ex-
perience in the treatment of disease, they would
find in it much to command their respect.
NEW YORK STATE HOMOEOPATHIC MEDICAL
SOCIETY.
The meeting of the New York State Medical
Society, in Albany, on the nth and 12th inst., was
of more than usual interest. Upward of a hundred
physicians were gathered together in council from
every part of the State, and judging from the pub-
lished proceedings, enjoyed themselves intellectually
and socially. We think it would add greatly to the
interest of these meetings, if the different bureaus
would collect and arrange in the form of a report,
concise, yet full enough to present clearly the lead-
ing facts, the discoveries, improvements, and prog-
ress in the different departments of medicine and
surgery during the preceding year. Quotations
could be made from papers presented, giving an
outline of the arguments, and stating the important
facts and deductions, leaving the papers themselves
to be published in the Transactions of the Society.
The reading of the reports would naturally bring out
a vast array of facts drawn from the experience of
the members, which would be of great practical value.
Most of the bureaus are now only so in name, and
so far as the collection of facts, experience and
scientific information are concerned, almost useless.
Dr. E. Darwin Jones, of Albany, was elected Presi-
dent of the Society for the ensuing year. No better
or more popular selection could have been made.
Dr. Jones will do credit alike to the Society and to
himself. Dr.H. M. Paine retires at his own request
from the secretaryship of the Society. No man in
the State has done so much for Homoeopathy as
Dr. Paine. Possessed of a thoroughly cultured,
quick and comprehensive mind and rare executive
abilities, he has worked nobly and well to advance
the cause of medical truth. He has edited nine
volumes of the Transactions of the Society, which, in
quantity and matter compare well with the publica-
tions of any other school. Thoroughly disinterested,
he has used his time and talents freely for the
public good, without expectation of reward, and
retires from the office he has filled so long and
well with the respect and good wishes of every
member of the Society.
SANITARY LEGISLATION.
Mr. Dorm an B. Eaton, a prominent lawyer in
New York,, recently gave an address before the
" Public Health Association " on Sanitary Legis-
lation in New York and England. Mr. Eaton
had just returned from a lengthy visit to Europe,
where he studied with the utmost care the workings
of the sanitary regulations of the different coun-
tries in which he sojourned, but more especially
those in England. After passing in review the
history of sanitary legislation in England and in
New York, he suggests the following as a few ofx
the organic measures of sanitary legislation greatly
needed, not only in this State but wherever there
is a dense population.
" 1. Co-operative sanitary legislation between the
Federal and State governments.
"2. A general law on the subject of public health,
with some special clauses applicable to all villages,
and others applicable to all cities ; our sanitary
legislation, in regard to cities and villages general-
ly, now being in the most confused, inefficient and
demoralized condition.
"3. General laws regulating every variety of medi-
cal practice, and the preparation and sale of medi-
cines ; under which those engaged in either shall
have an organization and authority for securing
(coupled with a duty of keeping up) a high stand-
ard of capacity and character, for examining all
candidates, for exposing all malpractice, and for
expelling all unworthy members.
"4. A central medical board having a classified
membership, with proper relations to the State
government, clothed with a supervisory control in
respect of all such organizations, and the studies
and standard of scholarship in all medical institu-
tions ; with the duty of looking into the sanitary
administration of every city and village of the
State, so far at least as to facilitate their harmoni-
ous action and to report their sanitary abuses ; with
the authority and obligation of examining into the
general sanitary condition and management of
every public prison, school, jail, poor-house and
public institution of charity or correction in the
State ; with the right to demand reports in respect
to all matters to which the supervision of such
boards should extend, and the duty of making an
annual report in respect of all such matters to the
Governor.
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63
" Such medical board should also have all the
authority in regard to medical education now be-
longing to the Regents of the University ; medi-
cine not being, any more than law or divinity, a fit
subject for the control of the Regents ; and such
board should also be an appellate tribunal in re-
gard to all medical societies. And in such medical
board (of which a part of the members should
not be physicians) there should be a bureau of
registration of births, deaths and marriages, with
authority to require full returns from every part of
the State. It should also supervise the enforce-
ment of compulsory vaccination throughout the
State. It is not less a calamity than a disgrace to
this great State to be without such a board of
registration.
" With sanitary administration upon such meth-
ods, properly reinforced and criticised by voluntary
organizations, much needless sickness and municipal
corruption would be avoided ; not a little pernicious
charlatanry and not a few poisonous medicines
might be suppressed ; the catalogue of crimes might
be reduced, and public morality and sanitary intelli-
gence might be greatly advanced.
"It is further indispensable, not only in this su-
pervisory health board, but in respect of all local
boards of health, that there be a divorce of sanitary
administration from party and village politics.
Until our people come to regard all sanitary laws
and precautions as measures based on science, ex-
perience and medical skill, and not as mere agen-
cies of caucus politics and party majorities, we can
never have the public health duly protected, or any
other results than corruption and inefficiency from
our sanitary administration. Nothing can be more
absurd than annual party elections of village poli-
ticians to administer our health laws. They are
generally utterly without qualifications, when elec-
ted ; and while in office for short terms, they stand
in constant fear of losing the votes of the bad men
they ought to coerce ; and by the time they have
gained a little sanitary knowledge, their terms of
office are expired. We have many stringent sani-
tary laws, so stringent indeed that any real enforce-
ment of them would raise a general protest. They
are in no sense enforced at all ; but the threat of
enforcement serves the purposes of mercenary offi-
cials and village demagogues. When the public
mind shall comprehend that in every local board of
health there must be united, medical skill, sanitary
knowledge and classified terms of several years' dura-
tion, so that there shall always be some experience
and courage for the work ; that every such local
board should be organized on the same principles,
and be subject to some general supervision, both in
regard to methods and to expenditures ; that our
methods of arresting disease must, no more than
the disease itself, be limited by mere political bound
aries or municipal jurisdictions; then, and not until
then, can we hope for that kind of sanitary admin-
istration, which the common safety requires, and
every consideration of economy and morality alike
commends. Until that time, our city and village
health laws and administration must, in the main,
continue a scandal to our institutions and a disgrace
to our political intelligence."
These suggestions deserve careful consideration.
Sanitary administration should be divorced from
party politics and medical cliques, and entrusted to
those, and to those only, of broad and comprehen-
sive views, willing to work not for the interests ot
party or sect, but only for the public good. When
the State insists upon this course, it will be the
signal for the downfall of the medical rings, the
most arrogant and despotic in the world, who have
so long, shut up within their narrow prejudices,
controlled the hospital and sanitary affairs of the
country.
The co-operation of sanitary legislation between
the Federal and State governments, we deem an
exceedingly wise and timely suggestion. We heartily
approve of the suggestion made in our last number,
in the article " On the Duties of the State in the
Prevention of Disease," of the formation by the
President, of a National sanitary board, which shall
be the supreme head in all matters relating to sani-
tary administration. Let every State also have its
sanitary board, directing the course of medical in-
struction, supervising our hospitals, asylums and
prisons, and keeping the local boards up to their
duty. Thus we should have sanitary law guided
by the wisest intelligence in the nation, exerting its
influence in every town and hamlet throughout the
land.
CHARITY STUDENTS.
We have a word to say against Charity Students
in connection with medical colleges ; and yet not
against the students themselves, for many of them
have and deserve our respect ; not against that
charity, which we love and humbly follow, but
against the system pursued in many colleges, of
giving free tuition to unworthy applicants, for the
sole purpose of swelling their list of graduates. We
do not recognize the plea or the fact of poverty as a
sufficient guarantee that the applicant will be either
a worthy member of the profession or a credit to the
college. We have no faith in that indiscriminate
charity that picks up a lazy and ignorant fellow and
makes a doctor of him because he is fit for nothing
else. Such charity will ''cover a multitude of sins"
sooner or later. Poverty has no claim to such con-
sideration, unless there are other equivalents which
make up for the deficiency in money. There must
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be a quid pro quo. Brains, character, energy, are a
larger capital than money, and the student who
possesses them will honor any college and adorn
any profession. Ignorance and laziness will, on the
other hand, disgrace even the lowest position in life,
and the higher the position, the deeper the dis-
grace. There are, then, two classes of charity stu-
dents ; one is rich in ability and poor in money,
the other is destitute in both mental and financial
resources. There should be a sharp discrimina-
tion between the two. It is unfair to the former
class of students to confound them with the latter,
and the fault of the colleges consists in not making
this distinction.
When a young man applies for free admission to
a medical college, he should be required to pass an
examination that will show him to be superior in
ability and general attainments to the ordinary run
of students. If this examination shows that he has
faithfully used his former opportunities, it will then
be wise to give him further opportunities for de-
velopment. Let this examination be rigid, impar-
tial and invariable, so that when one enters a med-
ical college on the footing of a " charity student,"
the title may be one of honor as being evidence of
the superior ability of the student. Such students
will be sure to repay all the advantages they receive
by the honor and influence they will reflect upon
their Alma Mater after graduation. As to the other
class of charity students, the poor, stupid and lazy,
it would be economy to pay them to stay away, it
would be strategy to send them to a rival college,
it would be charity to convince them that a good
carpenter or blacksmith is a better man in his way
than a poor doctor.
SEPTICEMIA.
In the recent Bulletins of the French Academy
we have a full report of M. Davaine's paper, and
the consequent discussion on Septicaemia. Septicae-
mia, he defines, as a disorder resulting from inocu-
lation with putrified blood, and refers to the facts
established by the researches of MM. Coze and
Feltz, in 1866, of the contagiousness of this disease,
and the increase of the virulence of putrified mat-
ter as it passed through the living organism. M.
Davaine first set himself to work to ascertain the
minimum quantity of putrified blood required to
kill certain animals, and then the proportionate dose
of their septicaemic blood which would suffice for the
same end. To carry out the second inquiry, it was
necessary to dilute the blood so as to get a fractional
part of a drop. He therefore mixed one drop of
the poisoned blood with one hundred of water, and
from this made his dilutions. The dose was in-
jected into the subcutaneous cellular tissue with a
Pravaz syringe.
Of seventy-two Guinea pigs, injected with from
one to ten drops of the blood, forty-three survived
and twenty- three died; of eleven other Guinea
pigs, none died from a less dose than one-fortieth of
a drop. Forty-eight rabbits were inoculated in the
same manner, in doses ranging from one to sixteen
drops of blood. Twenty-two survived and twenty-
six died ; of nine others, inoculated with fractions
of a drop, none died with less than one two-thous-
andth. To decide what dose of septicemic blood
(that is, the blood of an animal that has succumbed
to the inoculation of putrified blood) will cause
death, he resorted to a large number of interesting
experiments, and passes in review a series of twenty-
five successful inoculations.
Of the blood of an ox killed ten days previously,
in July, and very fetid, he injected into the subcuta-
neous tissue of the neck of five rabbits, quantities of
two, four, ten, twelve and fifteen drops respectively.
All five died — the first in sixteen days, the second in
nine, the third in forty hours, the fourth in twenty-
six days, and the fifth in five days, after the inocu-
lation.
Blood from the heart of a rabbit killed in forty
hours by the injection of ten drops of putrid blood,
was injected twelve hours after death into the cellu-
lar tissue of the neck of four rabbits. The four
rabbits, having received respectively one, two, three
and four drops of blood, died in one night, from
thirty to forty hours after the inoculation.
Blood from the heart of a rabbit, of the fourth
generation, was injected, tw6 hours and a-half after
its death, into three other rabbits, in doses .of one
drop, of one-tenth, and one-hundredth of a drop
respectively. The first and second died in fourteen
hours, the third in twenty hours.
Three rabbits were inoculated with the blood of
one of the ninth generation an hour after its death.
One received one drop, another one ten-thousandth
of a drop, and the third one twenty-thousandth.
The first died the next night, the second in fifteen
hours, and the third in about thirty-five hours, after
the inoculation.
At the fifteenth generation, three rabbits were in-
oculated with a twenty-thousandth, a thirty-thous-
andth, and a forty-thousandth of a drop of blood.
All three died in from twenty to forty hours after-
wards.
At the twentieth generation, the blood of a rabbit
an hour dead was injected, in doses of a five-hund-
red thousandth, a millionth, and a hundred-mil-
lionth, of a drop. Of the three rabbits that re-
ceived these minute quantities of blood, the first
and the third died in thirty-five hours, the second in
twenty-one hours.
In the following generations he reached quantities
whose minuteness was beyond all expectation. He
7 he Medical Union.
65
had ascertained, in 1868, that Guinea pigs could be
killed with doses of carbuncular blood smaller than
the millionth of a drop. He was assured of this by
experiments upon four of these animals, of which
two died from the ten-millionth, and two from the
hundred-millionth, of a drop of such blood.
In the twenty-second generation, three rabbits were
inoculated with a millionth, a hundred-millionth,
and a billionth, of a drop of the blood of a rabbit
dead two hours previously, which had been poisoned
by a five-hundred-millionth of a drop of septicemic
blood. These three rabbits died — two in about
thirty-six hours, one in forty hours.
In the twenty-third generation, one rabbit was in-
oculated with a hundred-millionth of a drop, an-
other with a ten-billionth. Both died in about
thirty-six hours after the inoculation.
In the twenty-fourth generation, five rabbits were
inoculated from the blood of another dead from the
hundred-millionth of a drop. The first received a
hundred-millionth, the second a billionth, the third
a ten-billionth, the fourth a hundred-billionth, and
the fifth a trillionth, of a drop of the heart-blood of
• this animal. All were dead before twenty-four hours
had expired.
In the twenty-fifth generation, four rabbits re-
ceived respectively a trillionth, a ten-trillionth, a
hundred-trillionth, and a quadrillionth, of a drop of
the blood of a rabbit belonging to the last series,
and perishing from the trillionth of a drop. One
only of these animals died, viz., that which had re-
ceived a ten-trillionth of a drop of blood.
On the next day he repeated in part the experi-
ments with the blood of the rabbit of the twenty-
fourth generation, which he had preserved for this
purpose.
Two rabbits were inoculated, the one with a tril-
lionth, the other with a ten-billionth, of a drop of
this blood. The first died in twenty-two hours, the
second in about thirty-five hours after.
It seems, then, that the limit of the transmissi-
bility of septicaemia in the rabbit stands at the tril-
lionth part of a drop of the septic blood.
He points out the greater certainty of death from
septicasmic than from simply putrid blood. All died
of the former ; only one-half of the latter. The
duration of life, he shows, has no relation to the
quantity of blood inoculated within the limits speci-
fied. The one great distinction lay in the quality
of the septicemic as compared with that of the
putrid blood. MM. Coze and Feltz admit the in-
creasing intensity of the septicasmic poison in the
successive generations. We know not how to insist
too strongly, they say, upon the remarkable circum-
stance, that the putrid ferment increases in activity
in passing through successive generations. He
proved the increase of virulence in the successive
generations in the following manner:
First Experiment. First generation.— The
blood of an ox preserved for ten days was inocu-
lated into five rabbits, in doses of a tenth, a fiftieth,
a hundredth, a five-hundredth, and a thousandth,
of a drop. The first three died ; and the two last
were, to all appearance, not even ill. The limit of
he mortal septicity of putrified blood in the rabbit
is, therefore, within a five-hundredth of a drop.
Second generation. — Blood from the heart of a
jabbit dead from a tenth of a drop was injected into
five rabbits, in doses of a ten-thousandth, a twenty-
thousandth, a thirty-thousandth, a forty-thousandth,
and a fifty-thousandth, of a drop respectively. All
died in from thirty-five to sixty hours.
Second Experiment. First generation. — From
the blood of an ox preserved for five days, five rab-
bits were inoculated, in doses respectively of one
drop, a hundredth, a thousandth, a two-thousandth,
and a ten-thousandth, of a drop. The first three
only died. The power of the virus to kill did not,
therefore, in these cases, reach the two-thousandth
of a drop.
Second generation. — The heart's blood of the rab-
bit dead from the hundredth of a drop was injected
into three rabbits, in doses of a hundred-thousandth,
a millionth, and a ten-millionth, of a drop. All
three died in from sixteen to twenty-three hours.
Third generation.-— -The blood of the rabbit dead
from the ten-millionth of a drop was injected into
five rabbits, in doses of a hundred-millionth, a mil-
lionth, a ten-millionth, a hundred-millionth, and a
trillionth, of a drop. All these rabbits died in
twenty-four or twenty-five hours.
These facts prove sufficiently that the septicemic
virus acquires its great potency at once.
He finds that septicemic blood loses its power of
causing disease and death as putrefaction advances
in it. Thus, on the ninth day after the decease of
its owner, it is still violent; but by the twenty-third
day it has become innocuous. He thinks the de-
struction of the virus is effected by the ammoniated
and hydro-sulphuric products of the putrefaction
process. This is illustrated by the phenomena of vi-
nous fermentation. Where much sugar is present in
the grape juice, alcohol is so rapidly formed that it
checks the further transformation of the sugar into
the alcohol itself. If the excess of alcohol be removed
by distillation, the process goes on again till all the
sugar is converted. In this way, he thinks, the pro-
ducts of putrefaction are consumed as fast as they
are produced, until the whole material, which is its
subject, becomes imbued with its virulent character.
In the animal organism, ammoniacal products are
rapidly eliminated by the kidneys ; hydro-sulphuric
acid introduced into the circulation is at once ex-
66
The Medical Union.
haled by the lungs. Thus the inoculated putrid
matter ferments, without interference, till the entire
mass of blood acquires an intense virulence.
The experiments made by M. Davaine, and the
results obtained, are full of interest to the medical
man and the scientific world. We should not, how-
ever, jump at the conclusion, from any of these ex-
periments, that the power of a drug must, of neces-
sity, increase by its dilution. There is a very marked
difference between the dilution of a drug and the
passing of a poison through one living organism
after the other. In the one case, the rapid spread
of putrefaction in the animal organism gives rise to
the virulence of the poison. In the dilution of drugs,
no such conditions exist. The complete and thor-
ough subdivision of a mineral or vegetable drug
does, undoubtedly, bring it more directly in contact
with the living organism, but we can find no argu-
ment for the extreme infinitesimal theory, upon any
of the experiments enumerated above.
iCransactions of Societies,
NEW YORK STATE HOMOEOPATHIC MEDICAL
SOCIETY.
FIRST DAY.
The twenty-second annual meeting of the society
was held in the Board of Supervisors' room, City
Hall, at ten o'clock, Tuesday, February n, 1873.
Dr. H. A. Houghton, of Keeseville, N. Y., Presi-
dent of the Society, called the meeting to order.
Prayer was offered by the Rev. Samuel McKean, of
Ash Grove Church, Albany, after which the Presi-
dent delivered the following address :
Gentlemen of the New York Ho?nceopathic Medi-
calSociety : — Another year has passed since we met
in this city to exchange opinions relative to the
treatment of disease, report cases from our own ex-
perience, and discuss scientific papers.
We have again assembled here for mutual im-
provement and for the good of those entrusted to
our care.
During the interval our acquaintance has been
extended, friendship strengthened, experience en-
larged, and the union of feeling which has marked
the progress of the society was never stronger than
to-day.
Our pleasure is terripered by sadness, as we miss
from their accustomed places, those whose work was
finished here, and well done, too.
Last in the roll of those who are not, for they have
been taken, stands the revered name of Dr. Jacob
Beakley, one who entered the ranks among the
early pioneers, when it required earnest convictions
and great courage to be an advocate of the new faith,
but who has lived, like our honored ex-President, to
see the truths for which they so valiantly fought
accepted, even beyond their brightest hopes. Full
of years and experience, he has laid him down to rest.
Receiving their discharge sooner, although young-
er in years, are the well-remembered names of Dake,
Hawks, Richards, and Shattuck. Blessed be their
memories. We shall deeply feel the want of their
counsel and support in this our common cause ; and
while we mourn our own loss, let us not forget
the aching hearts whose lives were more closely
entwined with theirs than ours have been, and give
them sympathy and aid, too, if need be, as far as-
possible.
While death has erased from our roll shining
names, life has brought us accessions from every
source, so that our society seems in a more prosper-
ous condition than ever— several hospitals, numer-
ous dispensaries, and a large number of county
societies, all of which are in active operation, with
increased demands, contributing largely to the inter-
est and welfare of this, the parent.
The college in the city of New York, which has
entered upon its thirteenth year, is not excelled in
its advantages or reputation by any other medical
college of its age in the United States. Its new edi-
fice, which has been completed during the past year,
equals, if not surpasses, in beauty and convenience of
structure, that of any other medical college in our
country. The honored names of its faculty is sufficient
guarantee of the unparalleled advantages to be en-
joyed by those students who are wise enough to
embrace the opportunity. The professors are
educated men, scientific in their practice and enthu-
siastic in their profession, able to give practical illus-
trations as well as theories..
Let us patronize our own College, and while doing,
so, may no homceopathist forget the debt of grati-
tude due to the unexampled generosity of Mrs.
Emma Keep, for her magnificent donation of one
hundred thousand dollars to help establish and
sustain an ophthalmic Hospital in connection with
the College. I am sure her name will be revered by
those sufferers who are benefited by her bounty,
and it should be no less so by all who are interested
in the cause of humanity or the progress of our sci-
ence.
There seems no more fitting expression of grati-
tude to the Giver of all good, than by using the means
with which He has endowed us, for the benefit of
his children ; and our kind patroness has built a
lasting monument to her own name and that of her
departed husband, in the means she has provided
for the amelioration of the painful condition of a
large class of afflicted ones.
The demands upon us are increasing even beyond
our proudest hopes. The immense gain in our
practice, which has taken place within the recollec-
tion of all present, seems like some wonderful story
of the imagination instead of verified truth.
Now, the question arises, what are we doing to
satisfy this demand ? Perhaps, all in our power.
But I would again suggest, as it cannot be too for-
cibly impressed upon our minds, the propriety of
greater strictness on the part of our medical col-
leges, with regard to certificates of time and moral
character, from the preceptors of graduating stu-
dents, co-operation on the part of physicians on
this point, that every method may be adopted for
sending them to their patrons thoroughly qualified,
with the exception of that experience which is only
the result of time.
I have received from the Regents of the Universi-
ty of this State a formula of the examinations which
they require from medical students, and which I
would recommend to your attention, for we have
no occasion to fear too great advancement in a pre-
paratory course.
The Medical Union.
67
Again, I trust that no one who claims to be a fol-
lower of the high-minded Hahnemann will be
guilty of dishonorable treatment towards his patrons
or professional brethren.
, I claim that harmony among ourselves is absolute-
ly essential to proper advancement, granting each
the right, of course, to the expression of his own
opinion, yet exhibiting a spirit of charity towards all,
recommending by its exercise the cause which we
represent.
I would recommend an expression of thanks to
the Chief Magistrate of this nation, for his advance-
ment in the recognition of our rights as physicians ;
also, to Ex-Governor Hoffman, for his endorsement
of the bill appointing a Board of Medical Exami-
ners, in connection with the University of this State.
Without trespassing longer upon your time, I
thank you for your thoughtful co-operation during
the past year, and leave this meeting to your pleas-
ure, only asking that no time be unnecessarily spent,
and that each hour be occupied by reports and dis-
cussions of value to the profession.
The Secretary, Dr. H. M. Paine, of Albany, read
a synopsis of the minutes of the last annual and
semi-annual meetings, which were, upon motion,
adopted.
The President announced the following commit-
tees:
Committee on Credentials — Drs. L., B. Waldo and
Mull.
Co7nmittee on Business— -Drs. S. D. Hand and
F. L. Vincent.
Committee to invite the members of the Legislature
to attend the sessions of the society — Drs. H. M. Paine,
T. F. Smith, and W. J. Bryan.
Committee to consider the suggestions' proposed
in the Presidents address — Drs. E. M. Kellogg, A.
P. Throop.
Committee on Nominations — Drs. J. R. White,
B. F. Cornell, L. M. Pratt, E. P. K. Smith, and E.
B. Holmes.
Dr. Hunting, the Treasurer, read his report, which
was, on motion, referred to a finance committee
consisting of Drs. Hasbrouck, F. F. Smith, and
Little. The receipts during the year were $572.65.
The expenditures were $516.65 ; leaving a balance
on hand of $56.
AFTERNOON- SESSION.
The President called the meeting to order, when
Dr. Throop, from the Committee on Gynaecology,
read a paper which he had prepared for the Materia
Medica Bureau, on the effects of the Pinus Lamber-
tiana (Sugar Pine) as a cathartic. He also read
another paper entitled The Importance of Explora-
tion or Diagnosticating Diseases of the Uterus.
Dr. Vincent gave a synopsis of two interesting
cases which came within his practice.
Dr. Waldo gave his experience in the use of elec-
tricity, in the case of certain diseases, giving some
interesting instances of its use in his practice. This
subject was discussed fully and ably by Drs. Waldo,
Throop and Cornell.
Dr. Throop read an article written by Dr. L. M.
Pratt, on the inversion of the uterus.
Dr.' Vincent exhibited an instrument called the
Intra-uterine Syringe.
Dr. Waldo stated that Dr. R. Walter Hurtly, of
Chicago, was present, and moved that he be invited
to participate in the discussions of the society. An
amendment was offered and adopted that all mem-
bers of the profession present be invited to partici-
pate in the deliberations of the meeting.
The President announced that the annual ad-
dress would be delivered in the Assembly Chamber,
in the evening, at eight o'clock.
Dr. Seeger read the report of a case by Dr.
Wilder, of Hartford, on aneurism of the femoral
artery, cured by compression, and exhibited a draw-
ing of the tumor.
Dr. Seeger also presented and described an im-
proved Laryngoscope.
Dr. Franklin Smith, of New York, read an in-
teresting article on obstetrics.
' Dr. Throop exhibited an improved fountain
syringe.
ANNUAL ADDRESS.
In the evening the annual address was delivered
in the Assembly Chamber, by Dr. J. W. Dowling,
of New York. The following is a synopsis of his
address :
After referring to the conclusive argument of
Wendell Phillips, in which he endeavors to prove
that the ancients were the equals of the present
generation, and that recent discoveries are merely
revivals of arts and sciences long lost to the world,
the doctor noted the fact that on the subject of
medicine Mr. Phillips was silent — probably from
the fact that such an advanced state of civilization
existed that no such science was needed. For it
is contended by many intelligent men, at the
present day, that health depends upon certain
conditions, which, if observed, will render medi-
cine entirely unnecessary. These sciences and
arts, if they did exist, were lost. They had, how-
ever, been revived, re-discovered, until, at the
present time, there hardly seems room for ad-
vancement. He referred to the rapid improve-
ments which had been made within the recol-
lection of many present, in everything necessary
for the comfort of man. With these improvements
sickness had increased, the life of man was render-
ed shorter than then. With this increase of sick-
ness comes a necessity for more skill with which
to combat disease. He quoted some amusing pre-
scriptions from a work on the subject of medicine
published some 300 years ago, and then took up
the method of treatment in vogue at the beginning
of the present century, and alluded feelingly to the
barbarous custom of bleeding, purging, blistering,
cupping, etc., then in vogue, and showed con-
clusively that until the introduction of homoeopathy,
but little advance was made in medicine. Since
that time matters had changed. The so-called
regular physicians had discovered — the people,
their patrons, had discovered — that disease could be
cured without resorting to this debilitating and cruel
method. Until now scarcely an intelligent physi-
cian of the so-called regular school of medicine
ever resorted to the use of the lancet for the cure
of disease.
He alluded to the advance which homoeopathy, as
a science, had made within the memory of the
youngest present, particularly in our own, the Em-
pire, State, and referred to the high position which
the New York Homoeopathic Medical College, of
which he is the executive officer, had attained, ad-
vised union and good fellowship with all, whe her
differing in convictions or not, and closed by quot-
ing from a medical author a beautiful eulogy on the
68
The Medical tlnion.
practice of medicine, which was as noble an art as
ever taxed the intellect of man, claiming that the
duties of the physician commenced with the first
feeble breath of the new-born infant, and he was the
watchful sentry until its due expansion should enable
it to receive these treasures with which the minister
was prepared to store it. Henceforth their duties
laid side by side, body and soul within their keeping,
until a greater and mightier minister than either
should dismiss the guard.
At the conclusion of the address, the members
adjourned to Congress Hall, where a collation was
tendered them by the members of the Homoeo-
pathic Medical Society of Albany County.
SECOND DAY.
The President called the meeting to order at 9
A. M. Dr. Gray presented a report on medical edu-
cation, and accompanied his report with some in-
teresting remarks.
Dr. Searle, chairman of the Bureau of Ophthalmo-
tology, presented a report.
Dr. White gave a very interesting history of the
case of a man who had become blind, caused by
cataract ; had been blind in one eye for sixteen
years, and who was accidentally hit in the eye by
the corner of a card, and afterward recovered his
sight.
Dr. Searle said that undoubtedly the sudden rup-
ture of the cataract had caused the desired effect.
Other interesting cases were stated by Dr. White
and other physicians.
The Nominating Committee for Officers for the
Ensuing Year made the following report, which was
received and adopted :
OFFICERS FOR 1 873.
President — E. D. Jones, Albany.
First Vice-President — D. F. Bishop, Lockport.
Second Vice-President — J. Ralsey White, New
York.
Third Vice-President — R. E. Miller, Chenango Co.
Recording Secretary — Frank L. Vincent, Troy.
Corresponding Secretary — L. M. Pratt, Albany.
Treasurer — Nelson Hunting, Albany.
Censors — Northern District: Geo. W. Little,
Fort Edward; H. D. Brown, Potsdam; S. J. Pear-
sail, Saratoga Springs. Southern District : J.
Franklin Smith, New York ; H. E. Morrell, Brook-
lyn; H. N. Avery, Poughkeepsie. Middle District:
S. C Warren, Jordan; A. E. Wallace, Oneida; E.
P. K. Smith, Auburn. Western District : T. C.
White, Rochester; W. B. Brown, Palmyra; H. S.
Hutchings, Batavia.
Publishing Coimnittee — Drs. F. L. Vincent, Troy ;
H. M. Paine, J. W. Cox, E. D. Jones, and L. M.
Pratt, Albany.
Nominees for Honorary Membership — Drs. G. A.
Hall and R. Ludlum, of Chicago, 111.
Nominees for Permanent Membership — First Dis-
trict : A. P. Throop and S. P. Burdick, New York.
Second District: A. E. Sumner, Brooklyn, and
Benjamin Lansing, Rhinebeck. Third District : E.
S. Coburn, Troy ; S. H. Carroll, Albany. Fifth
District: Selden F. Talcott, Waterville. Seventh
District: B. F. Grant, Bath, Steuben County. Eighth
District: Levi Shafer, Kingston.
BUREAUS.
Materia Medica — S. Lilienthal, M. D., New
York; S. D. Hand, M. D., Binghamton.
Surgery — W. Tod Helmuth, M. D., New York;
Theo. C. Liebold, M. D., New York; H. G. Preston,
M. D., Albany
Ophthalmotology — W. S. Searle, M. D., Brooklyn ;
Theo. C. Liebold, M. D., New York; T. F. Allen,
M. D.,1 New York.
Clinical Medicine — B. F. Cornell, M. D., Fort
Edward; E. A. Munger, M. D., Waterville; L. B.
Wells, M. D., Utica; Geo. E. Belcher, NewvYork :
W. W. Watson, M. D.
Mental and Nervous Diseases — H. D. Paine,
M. D., New York; Robert McMurry, M. D., New
York.
Obstetrics—}. Ralsey White, M. D., New York;
H. M. Paine, M. D., Albany; B. F. Cornell, M. D.,
Fort Edward.
Gyncecology — A. P. Throop, M. D., New York;
F. L. Vincent, M. D., Troy; J. R. Wood, M. D.,
New York.
Pedology— H. C. Houghton, M. D., New York.
Pharmacy— H. M. Smith, M. D., New York.
Histology —A. E. Sumner, M. D., Brooklyn.
Publishing Committee — Dr. F. L. Vincent, Troy ;
Drs. H. M/Paine, J. W. Cox, E. D. Jones, L. M.
Pratt, Albany.
Climatology — L. B. Waldo, M. D., Oswego; S.
D. Hand, M. D., Binghamton; C. A. Church, M.
D., Norwich; H. N. Avery, M. D., Poughkeepsie.
Vital Statistics— -E. M. Kellogg, M.D., New York.
. Vaccination — F. L. Vincent, M. D , Troy; F. W.
Ingalls, M. D., Kingston ; M. W. Campbell, M. D.,
Troy.
Aledical Education- — J. F. Gray, M. D., New
York; J. W. Dowling, M. D., New York.
Medical Societies and Institutions — H. M. Paine,
M. D., Albany.
DELEGATES
Delegates to American Institute — Drs. E, M. Kel-
logg, T. F. Smith, E. P. K. Smith, B. F. Cornell,
R. S. Bishop, A. T. Bull and C. Sumner.
Delegates to Connecticut Medical Society — Drs.
Theo. Quick, New York ; H. M. Paine, Albany ;
F. L. Vincent, Troy.
Delegates to Illinois Medical Society — Drs. W. H.
Watson, Utica; E. M. Kellogg, New York; E. D.
Jones, Albany.
Delegates to Indiana Medical Society — Drs. E. G.
Cook, Buffalo; J. W. Cox, Albany; H. Schwitz,
Schenectady.
Delegates to Iowa Medical Society — Drs. W S.
Purdy, Corning ; J. F. McKown, Albany ; N.
Hunting, Albany.
Delegates to Kansas Medical Society — Drs. J. H.
Demarest, New York ; Thomas J. Petit, Fort Plain ;
F. W. Ingalls, Kingston.
Delegates to Maine Medical Society — Drs. T. L.
Brown, Binghamton; P. W. Mull, Ghent; B.
Lansing, Rhinebeck.
Delegates to Massachusetts Medical Society— Drs.
H. D. Paine, New York ; T. Franklin Smith, New
York ; Charles A. Church, Norwich.
Delegates to Michigan Medical Society — Drs. E. B.
Holmes, Canandaigua; R. E. Miller, Oxford; B.
M. Lawrence, Port Jervis.
Delegates to Minnesota Medical Society — Drs. T.
F. Bishop, Lockport; D. W. Vanderburgh, Ilion;
Wm. Tod Helmuth, New York.
Delegates to Missouri Medical Society — Drs. N.
Getman, Richfield Springs; C. H. Adams, Canas-
tota; A. E. Wallace, Oneida.
The Medical Union.
69
Delegates to New Hampshire Medical Society —
Drs. H. A. Houghton, Keeseville ; N. R. Seely, El-
mira ; Ira W. Owens, Sherburne.
Delegates to New Jersey Medical Society — Drs.
H. M. Smith, New York; J. R. White, New York ;
J. W. Dowling, New York.
Delegates to Ohio Medical Society — Drs. E. P. K.
Smith, Auburn; R. S. Bishop, Lockport; E. M.
Kellogg, New York.
Delegates to Pennsylvania Medical Society — Drs.
S. D. Hand, Binghamton ; H. Sayles, Elmira ; A.
P. Hollett, Havana.
Delegates to Rhode Island Medical Society — Drs.
W. H. Randel, Albany; E. S. Coburn, Troy; H.
Willis, Brooklyn.
Delegates to Vermont Medical Society — Drs. H A.
Houghton, Keeseville; E. C. Lowe, Plattsburgh; E.
C. Bass, Cazenovia.
Delegates to Wisconsin Medical Society — Drs.
A. T. Bull, Buffalo; G. W. Peer, Rochester; W.
S. Searle, Brooklyn.
The semi-annual meeting of the society was ap-
pointed to be held in Brooklyn, on the second Tues-
day in September.
On motion, a committee was appointed to draft
resolutions expressive of the appreciation of the
services rendered by the retiring Secretary, Dr.
Paine, which motion was afterward amended, pro-
viding for engrossing the resolutions.
A committee was also appointed to collect and
refund to Dr. Paine, the amount he has advanced in
the interests of the society.
The secretary read a number of letters from hon-
orary members regretting their inability to attend
the annual meeting of the society ; also letters from
the secretaries of other state homoeopathic medical
societies.
After the adoption of a resolution of thanks to the
retiring officers, to the officiating clergyman, the
Mayor and Board of Supervisors for the use of the
room, and the Legislature for the use of the Assem-
bly Chamber, the society adjourned.
The meeting was well attended, upward of a
hundred members being present, representing the
several county societies in all parts of the State.
There was present a greater number than usual of
the members in middle age — those who are actively
engaged in practice. The tenor of the papers read
were short and eminently practical rather than
theoretical. The meeting proved one of the most
interesting, harmonious and instructive ever held by
the society.
F. L. Vincent, Rec. Secretary.
NEW YORK MEDICAL SCIENCE ASSOCIATION.
The annual meeting of the New York Medical
Science Association was held at Dr. Minor's, Jan. 14.
The following physicians were elected officers for
the ensuing year : Dr. Egbert Guernsey, President ;
Dr. L. Hallock, Vice-President; Dr. W. N
Guernsey, Recording Secretary; Dr. Doughty,
Corresponding Secretary; Dr. Freeman, Treasurer;
Dr. Minor, Librarian. The treasurer presented
his report for the year, which showed a surplus in
the treasury. The librarian reported that several
contributions had been made to the pathological
department. He also said that the society were
promised a large donation of books for their library.
The Medical Science Association held their next
monthly meeting on Feb. 1 ith.
Dr. Minor mentioned the case of ovariotomy, re-
ported in the second number of the Medical
Union, and presented the cyst to the pathological
department. He operated on the 6th of November,
and in his report in the UNION, on Jan. i8th, says :
"One ligature still remains, although the patient
is in perfect health, and able to work as well as
ever." The complete separation did not occur un-
til three months after the operation.
In an answer to a question, Dr. Minor said he
preferred ligating the pedicle to either torsion or
the clamp. He uses strong silk ligatures, and thinks
they do not act as foreign bodies in the peritoneal
cavity as the advocates of torsion claim.
Dr. Blumenthal reported a case of retained and
attached placenta having been successfully treated
by the injection of the umbilical cord. His method
is to incise the cord into the vein, and to inject
through it, to the placenta, a couple of ounces of
water. It was easy of accomplishment, and speedy
and effective in its action.
Dr. W. N. Guernsey said, that although he was
cognizant of this method of removing retained
placentas, he had never tried it, as he thought it
might not be entirely void of danger. He thought
that the water might be injected with such force as
to lacerate the walls of the vessels, so that air might
gain entry into the maternal sinuses cf the placenta,
and thence be rapidly carried to the heart, and
cause sudden death. Pressure and friction over
the fundus uteri, if persistently applied, usually
sufficed to stimulate sufficient contraction to expel
a retained placenta.
Carl Rokitansky said, that in several thousand
midwifery cases, occurring in the Vienna Plospital, it
was necessary only four times to introduce the hand
within the uterine cavity to peel off the placenta,
and thus detach it.
Drs. Guernsey and Blumenthal narrated cases of
sudden death during the puerperal state, which
were supposed to be due to embolism.
Dr. Ellis, in some remarks upon the use of alcoholic
stimulants in fevers, said that in his experience they
were the most beneficial in the early stages. Then
they would feed the system, nourish the brain, thus
calming the delirium, and producing sleep. Later
on, the nervous system had undergone two great
chemical changes ; it was too much depressed and
exhausted to be repaired by alcoholic stimulus.
Now, he thought it irritated, depressed and para-
lyzed. In this stage he relied upon the stimulus of
easily-digested feed given at short intervals, and
upon Arsenicum.
Dr. Blumenthal commended highly Tokay wine
as an alcoholic stimulant. He said it took the place
of food more fully than any other wine. Dr. Liebold
spoke of its being the only wine which contains
phosphorus. Dr. W. N. Guernsey considered it
extremely valuable in cholera infantum, and in the
chronic intestinal catarrh of children.
Dr. Liebold reported cases of nevus on the eye-
lids, which he had treated by tearing and rupturing
the blood vessels.
He places an instrument underneath the eye-lid,
upon which pressure is to be made, and with another
instrument presses firmly upon the lid, moving it to
and fro, over the substance beneath. Thus a por-
tion of the vessels are lacerated, and adhesive in-
70
The Medical Union.
flammation, and eventually absorption takes place.
If the nevus is large, he only operates upon a small
portion of it at one time.
He was led to think of this method while treating
an extensive nevus on the upper eye-lid, which had
returned after all the usual treatment had been
used. Determined not to be baffled, he originated
this form of treatment, which was entirely successful.
Since, he had tried it in several cases, and in all
with favorable results.
W. N. Guernsey, Recording Secretary.
MEDICAL SOCIETY OF THE STATE OF
NEW YORK.
The Medical Society of the State of New York
met February 4th, 1873, in the public hall Perry
Building, at Albany. The meeting was called to
order by the President, Dr. C. R. Agnew, of New
York. Prayer by the Rev. Dr. Clark, after which
the President read his inaugural address.
The spirit of the whole address seems to be
liberal. He says : " We cannot be unconscious of a
struggle that is being waged. A struggle between
conservatives on the side of a classical and literary
education and a class of reformers ardently in favor
of a more purely scientific and utilitarian scheme.
Nor can we fail to see that a middle party is form-
ing, both in this country and in Great Britain,
which is engaged essentially in the work of reconcil-
ing the contestants, so that we may have the
classics preserved in their proper place and the
sciences better taught and better learned, be-
cause taught and learned by those who shall have
had their minds regularly opened and invigorated
by sufficient and skillfully- arranged classical and
scientific courses We hear on all skies that we
need a higher tone in our medical schools, and that
doctors are goiiig up and down in society whose
medical sheep-skins do not cover or indicate their
true character. No one will deny that the more dis-
ciplined minds we have in our profession the better.
" When Harvey published his theory of the cir-
culation of the blood his practice fell off, and the
medical profession stigmatized him as a fool. ' The
few good things I have been able to do,' said John
Hunter, ' have been accomplished with the greatest
opposition.' Sir Charles Bell, while employed in
his important investigations as to the nervous sys-
tem, which issued in one of the greatest of physio-
logical discoveries, wrote to a friend: 'If I were
not so poor, and had not so many vexations to en-
counter, how happy would I be.' But he himself
observed that his practice quickly fell off after the
publication of each successive stage of his dis-
covery."
He recommends : " 1st. To encourage those to
enter our medical schools who shall have passed
honorably through a reputable academic college.
"2d. To broaden and make more thorough within
the schools the work in the institutes of medicine,
anatomy, physiology and chemistry.
" 3d. To create post graduate courses or fellow-
ships for those who have proved themselves able
and willing to search for the truth in any subject
connected with the science and art of medicine,
and to ensure to such laborers an adequate living so
long as competent official observers recognize their
industry, not to say their success."
But the best point of the whole address seems to
us to be his recommendation in regard to the ten-
dency which exists to modify the code of Ethics
and the recommendation that all such questions be
impartially discussed although they may be un-
pleasant. The address was well written and well
received, and reflects credit upon the President and
the society.
The Committee on the President's Address con-
sisted of Drs. Vanderpoel, J. P. Gray, Ernst
Krackowizer. This committee reported in favor —
1st. Of constructing a State Hospital for epilep-
tics.
2d. Of the appointment by the Board of Regents of
the University of the State of New York of a Board
of Examiners according to an act passed by the last
Legislature.
3d. Directing the Secretary to urge upon county
societies the formation of a committee on hygiene.
4th. Recommending a Committee of Conference
with other State Societies with a view to improving
the American Medical Association.
A large number of papers were presented of more
or less value and referred to the Publishing Com-
mittee. The time of holding the annual meeting
was changed to the month of September, and after
the appointment of the usual committees and a
few words of farewell by the President, the society
adjourned.
Isfeuis 3tem$.
BOSTON. — The mortality of Boston in 1872 ex-
ceeded that of 1 87 1 by 37 per cent. Excluding
small-pox, the excess was 25 per cent.
Scammon Hospital of Chicago. — The ball
given by the Ladies' Aid Society, for the benefit of
this hospital, realized $600, net.
Chicago Homceopathic Hospital. — The na-
tional banks of Chicago have given $1000 for the
use of this hospital.
" Hygiene," a magazine devoted to the discus-
sion of sanitary topics, has appeared. It is pub-
lished twice a month, is impersonal in editorship,
and hails from No. 46 East 14th street. Its ap-
pearance is neat, and its articles brief, but perti-
nent.
A New Journal is also announced to be pub-
lished monthly, in the interests of the N. Y.
Homceopathic Medical College.
A New Magazine devoted to the interests of
Sanitary Science, in its broadest aspects, is an-
nounced by circular. The Sanitarian, as it is to be
called, is to be edited by Dr. A. N. Bell, of Brook-
lyn, N.Y., and published monthly by Messrs. A. S.
Barnes & Co., of this city. Dr. Bell's experience
as one of the Quarantine Commission, and in the
U. S. Navy, together with his extensive knowledge
in all that pertains to sanitary subjects, render him
peculiarly fitted for undertaking such a work
Bellevue Hospital Medical College.— This
institution held its twelfth annual commencement
Thursday Evening, Feb. 27th, at the Academy of
Music. The address to the graduates was given by
the Hon. John R. Brady, and the valedictory ad-
dress by Dr. John R. Kinney, of Hawaii, Sandwich
Islands. The graduating class numbers 167 mem-
bers.
The Medical Union.
n
College of Physicians and Surgeons. —
This, the oldest of 'our New York medical colleges,
held its sixty-sixth annual commencement, Thurs-
day evening, Feb. 27th, at Steinway Hall. The
graduating class numbers 104 members. The ad-
dress to the graduates was given by the Rev. Dr.
Henry E. Potter, and the valedictory address by
Dr. Qharles Kelsey.
Albany City Dispensary. — The trustees of
the Albany City Dispensary have purchased the
three story brick building No. 75 Division street,
the first door east of South Pearl street, to be used
for a dispensary and also for the establishment of
a homoeopathic hospital. The location is central
and easy of access. The building is in excellent re-
pair and will afford hospital accommodation for
from twelve to fifteen patients at one time.
The Woman's Hospital. — 219 Patients were
admitted to this hospital last year, 676 treated at
their homes, and 2,237 in the dispensary; total,
3,132. The number of patients in the hospital ex-
ceeded those of any previous year. Donations
have been received of $5,000 from Anna J. Steel ;
$500 from Dr. R. J. Dodd, and $8,000 in the name
of his deceased wife, for the endowment of a train-
ing school for nurses in connection with the hospital.
The Royal Humane Society of London has
presented a gold medal and a vote of thanks to
Capt. Mouland of the Cunard Steamer Batavia, for
the rescue of the officers and crew of the bark
Charles Ward, wrecked at sea. The other officers
and the seamen of the rescue party also received a
reward in money and the thanks of the society.
The Cunard Company has also rewarded the sea-
men and promoted the officers.
Bellevue Hospital. — The official statistics of
the Bellevue Hospital for the year ending February
1, are: Outdoor poor (Bureau of Outdoor Relief),
67,988 ; Number of prescriptions issued, 80,637 ;
Increase of patients over last year's number, 2,149 5
Increase of prescriptions over last year's, 8,468 ;
Number of ambulance cases for the year, 1,478;
Police cases, 462 ; Coroners' cases, 463 ; Deaths,
1,142 ; Number of Patients in hospital at the close
of this year, 659 ; Number of admissions for the
year, 6,324; Births, 414; Total number treated,
1,327; Sunstrokes, 107; Obstetrical cases, 454.
New York Homoeopathic Medical College.
— At the commencement of this institution, Thurs-
day evening, Feb. 27, at Association Hall, the fol-
lowing gentlemen received the degree of doctor of
medicine. Jas. E. Anderson, R. Heber Bedell, W.
W. Bennett, Frederick H. Bradner, Charles R.
Brown, W. H. Brown, Jas. H. Buffurn, Chas. E.
Chase, L. W. Cole, C. M. Conant, Wm L. Flem-
ing, John F Griffin, Aaron H. Hasbrouck, Dexter
Hitchcock, Barker C. Howland, Dwight B. Hunt,
Chas. E. Jones, Asa W. Jaynes, Geo. W. Lawrence,
Chas. A. Libby, S. Corwin Osborne, Henry D.
Ostrom, George W. Richardson, Francis R.
Schmucker, Daniel Simmons. Theo. V. Smith,
Geo. Tytler, Milton A. Wilson, Burdett Warren,
Henry Waters, F. G Welch, Howard A. Worley,
Win. H Krause, Wesley B. Perkins, Geo. B. Ross.
The address to the graduates was given by Prof. T.
F. Allen, and the valedictory address by Dr. Dwight
B. Hunt. A gold medal was awarded to Dr. Dexter
A Flitchcock for discoveries in materia medica.
University Medical College. — Owing to the
energetic and unwearied efforts of the Chancellor of
the University, Rev. Dr. Howard Crosby, the Aca-
demic department of that institution has recently
been organized on a free basis. It was a favorite
idea of the founder and first Chancellor of the Uni-
versity, Rev. Dr. Matthews, that in time the institu-
tion would not only be free in all of its departments,
but would occupy a position worthy the wealth, the
culture and science of the Metropolitan City. A
movement is now on foot to make the medical depart-
ment of the University free; and the faculty enter-
tain strong hopes that soon the institution will be
sufficiently endowed to enable them to throw open
its doors, free of charge, to all who wish to avail
themselves of its privileges. At the commencement,
on the 20th inst., we noticed the valedictorian of the
class was Dr. Clarence E. Beebe, a student from the
office of Dr. Guernsey. The address was an un-
usually scholarly and finished performance, and
spoke well for the literary and scientific culture of
the class. The Budd prize, considered the highest
in the class, was awarded to Dr. R. A. Murray.
All who pass the professors' examination without
missing a question, are entitled to compete for this
prize before a committee of five physicians. There
were five competitors, the examination lasting
over two hours and a-half, and covering the fields
of obstetrics and gynaecology. In the vote of the
committee three were for Dr. Murray, and two for
Dr. James B. Gilbert. Dr. Gilbert was a student
in the office of Dr. Guernsey, and leaves in a short
time for Europe to continue his studies in the hos-
pitals of Berlin and Vienna.
Medical Degrees.— The Legislature of New
York passed a law, May 16th, 1872, relating to the
examination of students for the degree of Doctor
in Medicine. As the law is an important one, and
its provisions have not been generally fully under-
stood by the profession, we publish a copy of it en-
tire. The Homoeopathic Board has been organized
with the following members : Drs. John F. Gray,
Millard and McVickar, New York City; Searle,
Brooklyn; H. M. Paine, Albany; Watson, Utica;
Munger, Waterviile; Vincent, Troy; and Avery,
of Poughkeepsie.
§ 1. The regents of the University of the State of
New York shall appoint one or more boards of ex-
aminers in medicine, each board to consist of not
less than seven members, who shall have been li-
censed to practice physic and surgery in this State.
$ 2. Such examiners shall faithfully examine all
candidates, referred to them for that purpose by the
chancellor of said university, and furnish him a de-
tailed report in writing of all the questions and an-
swers of each examination, together with a separate
written opinion of each examiner as to the acquire-
ments and merits of the candidates in each case.
% 3. Such examinations shall be in anatomy, physi-
ology, materia medica, pathology, histology, clini-
cal medicine, chemistry, surgery, midwifery, and in
therapeutics, according to each of the systems of
practice represented by the several medical societies
of this State.
§ 4. The said reports of examinations, and the
annexed opinions of the examiners, shall forever be
a part of the public records of the said university,
and the orders of the chancellor addressed to the
examiners, together with the action of the regents in
each case, shall accompany the same.
§ 5. Any person over twenty-one years of age, of
good moral character, and paying not less than
72
The Medical Union.
thirty-five dollars into the treasury of the university,
and on applying to the chancellor for the aforesaid
examination, shall receive an order to that effect,
addressed to one of the boards of examiners, pro-
vided he shall adduce proofs satisfactory to the
chancellor, that he or she has a competent knowl-
edge of all the branches of learning taught in the
common schools of this State, and of the Latin lan-
guage, and that he has diligently studied medicine,
not less than three years, under the direction of one
or more physicians duly qualified to practice medi-
cine, or has himself been licensed, on examination,
by some medical society or college legally empow-
ered to issue licenses or degrees in medicine.
% 6. The regents of the university, on receiving
the aforesaid reports of the examiners, and on find-
ing that not less than five members of a board have
voted in favor of a candidate, shall issue to him or
her a diploma, conferring the degree of Doctor of
Medicine of the University of the State of New
York; which degree shall be a license to practice
physic and surgery.
§ 7. The candidate, on receiving such diploma,
shall pay to the university the further sum of not
less than ten dollars.
§ 8. The moneys paid to the university, as afore-
said, shall be appropriated by the regents for the
expenses of executing the provisions of this act.
% 9. The regents may establish such rules and
regulations from time to time, as they may deem
necessary to insure the faithful execution of the
provisions of this act.
This act shall take effect immediately.
Brooklyn Homceopathic ' Hospital. — This
institution was formally opened on the 13th of Feb-
ruary, and dedicated to the service of the sick by
the Bishop of Long Island. The following des-
cription is from the Journal of Commerce : The
building stands on a slight elevation on the east
side of Cumberland street, about 150 feet north of
Myrtle avenue. To those who have visited other
hospitals in Europe and America, the appearance
of this will be an agreeable surprise. Its exterior
resembles the private residence of an opulent citi-
zen. Grand old shade-trees line the front carriage-
way, and a granite wall covers the flower garden
from the street. Passing up a short flight of stone
steps, the visitor reaches a broad flagged pathway,
on either side of which stretch the curious box-bor-
dered paths laid out by some English gardener
around the flower-beds. The path through the
garden, 75 by 60 feet, leads to the wide brown-
stone steps that approach the main doorway. The
building is of brick, three stories high, tinted in
light yellow, relieved with brown at the windows
and cornice. At the rear is a covered piazza, and
beyond it is a mortuary. Touching a bell, the front
door is opened by a servant, and the visitor enters
a broad hall. It seems to be yet the residence of a
gentleman of culture. On the right is a parlor
neatly upholstered, the room of the Board of Trus-
tees. On a bracket against the wall, is a bust of
Hahnemann. Paintings and architectural designs
have prominent places. Here all of the executive
business is done. Crossing the hall to the left is
the pharmacy of the house. On many shelves are
the drugs which are to work out into fact the
theorem " similia similibus curantur." At the end
of the hall is a door opening to a long, broad room
taking the space behind the trustees' room and the
pharmacy, and known as the " surgical ward."
Even here the ghastly associations of the room are
mollified by the superb collection of rare ferns and
flowers at each end of the room, kept under glass
shades that the air may not be vitiated. At the
eastern centre of this room is a door to receive
patients brought by carriages or ambulances and
entering the grounds from Carleton avenue, or the
rear of the hospital. At the south end of the room
is an elevator on which the wounded can be raised
to the wards in the upper stories without suffering
additional pain. Here also are well-arranged baths,
with hot and cold water, linen closets, lavaiories
and other accommodations. Opening to the east
of the surgical room is a broad, well-lighted, cover-
ed piazza for the convalescents. The view from
the casements is enlivened by stately trees and the
flowers of a luxuriant garden. To the left, opening
from the surgical room, is that necessary adjunct,
an operating room, with stations for students. On
the same floor adjoining the operating and the
pharmacy, is the female surgical ward, capable of
accommodating eight beds. Each ward is furnish-
ed with lavatories, water-closets and baths. The
broad staircase leading to the second floor intro-
duces the visitor to another department of the in-
stitution. There is the female medical ward, with
its clean linen, warm blankets, its bright gaslight,
marble basins, and dumb waiter to bring food from
the kitchen and medicines from the pharmacy. The
male medical ward, on the same floor, has similar
accommodations ; each ward having full light on
two or three sides. The thoughtful kindness of the
designers of this charity has devised coloring the.
walls with a pleasing shade of very light blue, thus
avoiding that horror of modern hospitals, deathly
white walls. Pictures will be contributed to give
pleasant occupation for the attention of the sick.
In the north wing of the building are rooms, ele-
gantly furnished, for the use of those who may be
taken sick, far from friends, or for those who have
no homes but boarding houses, where they are left
to themselves in sickness, and who can well afford
the means to remunerate the institution for the
benefits it confers. With this section is connected
a private staircase, by which friends can visit
patients without passing through the other wards.
The upper floors are arranged on a plan similar to
that of the second floor. At the close of the re-
ligious services the guests adjourned to the dispen-
sary of the hospital, where a bountiful collation had
been provided for them. After the good things
had been discussed, congratulatory speeches were
made, and four thousand dollars subscribed to the
building fund. The medical and surgical staff for
the first year are as follows : Medical Director, A. E.
Sumner, M. D; Surgeons, W. L. Fiske, M. D., H.
Willis, M. D., A. Varona, M. D.; Physicians, R. C
Moffat, M. D., W. S. Searle, M D., E. J. Whitney,
M D., W B. Garside, M. D., Geo. Bowen, M. D ,
S. E. Stiles, M.D., Edwin Minor, M. D.
Errata. —In printing Dr. Whitney's paper on
Laryngeal Phthisis on p. 9 of the Union, several
errors were made, the correction of which was re-
ceived too late for last month's issue.
On p. 9, column i, line 64, read •' cartilages of Wrisberg and
capituli Santorini."
Col. x, last line, " over" instead of " on."
Column 2, line ?, "fade into " instead of " fall " ; also in line 44
read " most subject to attack " omitting " an" ; p. 10, col. 1, line _o,
omit " are, "
The Medical Union.
73
iDriginal Articles.
ALCOHOLIC STIMULANTS.
By Egbert Guernsey, M. D.
The report of the Chief of Police in Boston, gives
the percentage of persons charged with crime in
each of the two great foreign nationalities of that
city. The result is as follows : Irish population,
56,900; German population, 5,606. Irish prison-
ers, 14,673; German prisoners, 364. The percent-
age of prisoners then, according to the population,
is Irish, 25.78; German, 6.49. This difference is
partly explained by the liquor consumed by the two
nationalities. The strong drink of the Irishman
contains from forty-five to fifty per cent, of alcohol.
The favorite drink of the German is lager beer,
holding only about five per cent, of alcohol. It is
easy then to understand why crime growing out of
intoxication is more common among the Irish, if we
accept as true, the statement often made that the
percentage of crime increases in proportion to the
amount of strong drink consumed.
The question is a pertinent one for us as a profes-
sion to consider, the effects of alcohol upon the hu-
man system as a stimulant and as a narcotic ; as a cu-
rative agent, contributing to physical health and in-
tellectual vigor, and as a pernicious poison sowing
the seeds of disease, crime and death.
Alcohol is classed among the neurotics, having an
action, first as a stimulant, second, in large doses, as a
narcotic. It is now pretty well settled, that the desire
for strong alcoholic stimulants increases in a direct ra-
tio to the temperature, and its fatality is more marked
in a dry atmosphere. In the colder climates the desire
is for strong alcoholic stimulants, while in the warmer
climates the system craves the lighter stimulants of
coffee, tea, etc. In the humid atmosphere of Eng-
land all forms of alcoholic stimulants can be taken
with less danger to the constitution than in the dry
and bracing atmosphere of the northern portions of
our own continent; within the isothermal lines of
770 Fahr. north, and south of the equatorial line of
820 Fahr. , the desire for stimulants is said to be o ;
and there is no intemperance from the use of alco-
holic drinks. North and south of this space, or be-
tween J j and 50° the grape vine grows to perfection
and light wines are the beverage common to all
classes. Here intemperance is rare and branded as
a crime whenever it does occur. Northward, and
perhaps southward of the line of 5 1 ° the grape vine
grows less luxuriantly, and gives an inferior yield
as well as quality of wine. This is the region of ar-
dent spirit-drinkers — -Russian, Scandinavian, An-
glo-Saxon, and Celtic of Great Britain. Ceylon
alone, of the lands south of 500, is a spirit-drinking
country. According to this law, the hotter the
country the less the desire for ardent spirits. Hence
the ravages of alcohol are confined more particu-
larly to the colder and more temperate regions. A
slight examination of alcohol as a narcotic, its de-
pressing and poisonous influence on the human
system will be sufficient to show that the stronger
forms of alcoholic liquors, such as brandy, whiskey,
rum and gin, should never be used except with ex-
treme care and only as a medicine.
Dissect down to a living nerve and surround it
with alcohol of a certain strength, as has often been
done, and we find, it becomes paralyzed at that point
and therefore incapable of transmitting impressions.
Dilute the alcohol largely with water and the para-
lyzing action of the poison is less apparent. If then
an animal absorbs into its circulation, a large quan-
tity of alcohol within a given time, the nervous
centres become more or less paralyzed. In addition
to this, physiological researches have shown that the
presence of a large quantity of alcohol in the blood
interferes materially with its absorption of oxygen.
Thus the integrity of the nervous system is only sus-
tained in proportion to the rapidity with which the
poison is eliminated through the lungs, the kidneys
and the skin. In moist climates this would be more
rapid than in a dry and bracing atmosphere.
Alcohol, in doses capable of producing drunken-
ness, has been demonstrated to be a true narcotic poi-
son, of the same class as the Anesthetics, Chloroform
and Sulphuric Ether. Given in large doses, it pro-
duces a suspension of nervous activity, a paralysis
more or less marked. This, combined with the de-
ficiency in vital power so common in chronic drink-
ers, accounts for the great nervous debility we see
in the delirious crisis. Alcohol is easily absorbed
into the system, and given in small doses in weak
and exhausted systems when there is a deficiency of
vital action, it acts as a healthy stimulus, toning up
the arterial and nervous systems, brightening the
faculties and improving the digestion. When
properly timed and given only in doses just suffi-
cient to gently stimulate, we get only its homoe-
opathic or tonic action, and never experience that
depressing reaction which is sure to follow the
stronger or more narcotic doses.
This is demonstrated by the Sphygmograph of
M. Marcy, which carefully registers every pulse
wave, showing the arterial tonicity present. Ap-
plying this test we find that the small vessels, relax-
ed from fatigue, are brought up by a small dose of
alcohol to a healthy action from which there is no
recoil. If* the dose has been large, or given when
the system did not require it, the Sphygmograph,
measuring carefully the pulse waves, shows an ar-
terial relaxation, and at the same time an accel-
erated pulse. If the dose has been sufficiently large,
symptoms of a paralytic nature are speedily ob-
served, confined at first to the spinal and the fifth
cranial nerves, and shown in the weakness of the
muscles of the extremities, and the numbness of the
lips. Steadily the narcotic influence marches up to
the cerebral hemisphere, and now comes the intel-
lectuaj confusion and the thickness of speech, the de-
lirium, the coma, and, if the system has been brought
completely under the influence of the poison, the
paralysis of the medulla oblongata and cardiac
nerves, and death. Usually the rapid elimination
of the poison from the system gives the nervous sys-
tem time to partially react before it is completely
paralyzed in its action. Notwithstanding a large
portion of the alcohol is eliminated from the body
in an unchanged form, yet we have every reason to
believe that a portion of it is converted into the in-
termediate compounds, between alcohol on the one
side and carbonic acid and water on the other, which
would represent the stages of transformation of the
former into the latter, thereby acting to a greater or
less extent, when given at proper times and in prop-
er quantities, in its various chemical transformations
and combinations as food. Of this point we shall
74
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speak farther on when we treat of the action of al-
coholic compounds as stimulants merely, promo-
ting health and comfort.
From what has already been said it is apparent
that alcohol should never be used as a narcotic. It
is full of danger, and is always followed by an un-
healthy reaction. There are other narcotics and
anesthetics by means of which we can obtain partial
or entire insensibility with but very little danger or
after unpleasant results.
It is very easy to see how the long-continued use
of a narcotic capable of producing such powerful
effects upon the nervous system, paralyzing to a
greater or less extent its action, impairing the vital
force by cutting off a portion of the nervous fluid
necessary to produce digestion, must, in time, pro-
duce a condition of the mind and body which amounts
to positive disease. The nervous system is starved
because it cannot take in through the process of di-
gestion the necessary amount of healthy nutrition.
The mind loses its true sensibility and is no longer ca-
pable of performing its healthy functions, and sooner
or later, in proportion as the nervous system is kept
under the influence of alcoholic narcotics, becomes
more or less incapable of self-control. The whole
nervous system is impaired and the keen sensibility
of the mind blunted to such an extent that he feels
himself powerless to reform. The craving of the
diseased system for its accustomed narcotic is more
powerful than the power of the mind to resist.
When the disease has reached this stage, there is
but one remedy, one plan only which holds out any
hope of permanent cure ; and that is, place him
where it will be utterly impossible to obtain alco-
holic stimulants, until the nervous organism can have
time to get back its healthy tone, and the mind
again asserts its old supremacy. Any inebriate asy-
lum which relies for a cure upon surrounding the
patient with healthy moral influences, relying upon
his honor to abstain from drink, must in this class
of cases (for which asylums are most needed) be a
failure. Are the moral influences of an asylum bet-
ter than those of wife, and children, and parents,
and friends ? Are its comforts more than those of
home? Nearly all our inebriate asylums recognize
the power of the patient to abstain from alcohol.
They surround him with healthy, moral influences,
and then place him upon his honor. They fail to
recognize the fact that those for whom asylums are
the one great remedy which hold out any hope of
permanent cure, are beyond the voice of honor.
They are mentally and physically diseased, incapa-
ble of self-control. You may as well talk of honor
to the maniac. The one cannot reason correctly —
he is a prey to the wildest illusions and fancies.
The other finds his will too weak to follow his con-
victions, and often contrary to his reason, in spite
even of his earnest struggles he is swept along by an
influence he has no power to withstand.
We pass now to the consideration of alcohol as a
stimulant, as a reliever of pain, and a supporter of
life. Every one will admit the claim of oxygen to a
place as a stimulant of the first rank. It relieves
pain, calms an excited circulation, soothes the brain
and promotes local nutrition. Compare the child
brought up in the close and crowded alley of a great
city with one who is permitted to roam over the
breezy hills and by the sea-side. In the one case,
we see a pale and sickly complexion, and often an
emaciated form ; in the other, cheeks ruddy with
health and a form full of muscular activity and
strength. One has had the stimulating effects of
oxygen, the other has been deprived of it. All arti-
ficial means are weak and uncertain in their opera-
tions when compared with this great natural stimu-
lus of life ; but when we get any useful effect from
our medicinal stimulants, we get the same quiet and
perfect action of the vital functions, the whole phys-
ical structure moving on in all its parts, without
undue waste or excessive growth, without hurry and
without pain. Upon the condition of the system
depends the kind of stimulant to be used, and
used only until the harmony of the system is estab-
lished and it is capable of performing its functions.
The real healthy life of an organism consists not in
the rapidity of tissue change, nor development of
heat or any other force, except so far as they minis-
ter to its preservation. The old idea that stimu-
lants are followed by depression, is an erroneous
one. When depression and confusion of intellect
follow what was intended as a mere stimulant, it is
convincing proof that it has been pushed too far and
we have obtained its narcotic action.
We plead, not for the habitual use of alcoholic
stimulants, but for their judicious use; when the
wasting energies' of the system need some aid, not
supplied by ordinary food, to spur into activity the
enfeebled organism given in these conditions, they
aid digestion and thereby facilitate the introduction
of nutrition into the system, and by harmonizing
and strengthening the circulation contribute to phys-
ical health and mental strength.
In all cases where alcoholic stimulants are pre-
scribed in sickness and in enfeebled constitutions,
the condition of the system should be carefully stud-
ied as well as the chemical combination of the stimu-
lant ; and in no case should it be pushed to narcosis,
or even to a point where it is followed by unpleasant
reaction. We give it to soothe and harmonize the
vital powers and to support the strength. Pushed
beyond this point we produce positive harm.
We have only to look carefully at the chemical
analysis of wines to see how rich they are in the
very elements of life, and to be convinced that under
certain circumstances they promote nutrition by con-
veying into the system those peculiar elements of
food which it needs to carry on the functions of life,
and which the organism, enfeebled by sickness
or overwork, has lost the power to assimilate from
ordinary food.
Besides water, which forms the largest percentage
of grape juice, we find as its constituents, sugar,
Gelatine, or Pectine Gum, fatty matter, Wax, Al-
bumen, Gluten and Tartaric Acid, both free and
combined with Potash, Soda and Lime ; while gen-
erally, or in certain cases, small quantities also are
present of Racomic, Malic, and perhaps Citric Acid,
Alumina, Oxides of Manganese and Iron, Sulphates
of Potash, Soda and Lime, Phosphates of Lime and
Magnesia, and probably Silica. In the skins we
have, besides coloring matter, Tannic Acid. The
solid matter of the juice in very ripe grapes may
amount to forty per cent. The sugar ranges from
thirteen to thirty per cent, of the weight of the juice.
In the process of fermentation a portion of the sugar
is converted into the products of alcohol, which
mostly remains in the liquid, and Carbonic Acid,
which usually escapes.
Thus we see we have in wines the very nutrition of
the soil, those constituents which go to make up nerve
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75
and blood and bone and tissues ; under the action of
light and heat, and air and water, the vines take out
from the soil the very elements of life, and fit them for
our use. Of course, wines are more or less stimulating
in proportion to the amount of alcohol they contain,
but strong alcoholic wines, notwithstanding they may
contain a large amount of nutritive matter, should
be used with extreme caution on account of the dan-
ger of producing the narcotic effects of the alcohol.
Of the foreign wines, Port is the richest in alcohol,
containing (according to Brande), from 19 to 23 per
cent. Madeira ranks next, containing from 17 to 22
per cent., while the red French wines contain only
from 7 to 14 per cent. Good Bordeaux contains 9,
10 and 11 per cent, of alcohol; Champagne, from
10 to 11 per cent., and Rhine wine from 6 to 12 —
generally from 9 to 10 per cent. A large variety of
the most delicate wines of Italy cannot be imported
on account of the small amount of alcohol they con-
tain. These wines, exceedingly delicate in flavor,
and often rich in nutritious matter, must be drank
in the country where they are grown. To many of
the foreign wines, alcohol, in greater or less propor-
tion, is added to fit them for our market ; and this
is one reason why they cannot be drank here with
the same freedom and the same beneficial results as
on the soil where they are grown. To all wines ex-
ported from the Continent into England, is added
more or less brandy, not Cognac, but corn, fig and
sugar-brandy. Thus the Rhine wines receive an
addition of 2.5 ; the French, 4.7 ; the Spanish and
Port wines. 8.15 per cent, of alcohol; and to that
exported to this country the percentage is much
greater.
Those countries in Europe which produce the
largest amount of wine are the most free from in-
temperance. In Hungary there are land owners who
produce yearly from 1,000 to 20,000 hogsheads of
wine. Beautiful and enormous cellars cut in rocky
mountains, widely extend their ramifications like
labyrinths or catacombs, where the wines are ranged
year after year. It is a kind of aristocratic and
family glory to have a full and rich cellar. And yet
in Hungary, there is but very little intemperance—
infinitely less than in England or in our own country.
In the island of Madeira, while the vineyards were
in full bearing, a drunkard could scarcely be found ;
but in the process of time, as the vineyards were de-
stroyed by disease and strong liquors were intro-
duced, intemperance increased to a frightful extent.
In our own country the true apostles of temperance
are those who plant vineyards, and bring to a high
state of perfection the native wines to be drank on
our own soil. Once crowd out the strong alcoholic
drinks and substitute in their places the light lager,
cider, and the native wines made from the grape,
elderberry, blackberry, and other fruits growing
on our own land, and we not only strike a death-
blow to alcoholic intemperance, but increase the ratio
of health and almost eradicate certain forms of disease
so common and fatal in our own climate. The bil-
ious dysenteries, diarrhoeas and fevers, the rheu-
matism and gastric disturbances, produced often by
the capillaries being clogged up with half-burnt
carbon and its chemical changes, would be sensibly
reduced in violence and frequency if the hepatic vis-
cera and the blood were kept in a more natural con-
dition by the free use of the ripe acid fruits and
their juices which an all-wise Providence has placed
at our doors. Many an attack of autumnal diar-
rhoea and other serious troubles coming on after or
during the heat of summer, I have cured with noth-
ing but the acid wines. In New England, rheu-
matic troubles were much less common before the
temperance mania swept like wild-fire over the
country than at present. Orchards were allowed to
die out, and old men, who all their lives had been
accustomed to the healthy and needful stimulus of
the juices of their own fruits, religiously abstained
from them. Legislation which fosters the growth of
wines, so that they can be placed in their purity so
cheap as to come within the reach of all, is much
wiser than that short-sighted policy which places
the ban of the law upon all alcoholic liquors.
No country in the world is better adapted to the
growth of wines than our own ; and this branch of
industry, although in its infancy, is already giving us
magnificent results. Some of the wines of our own
country are now equal, if not superior, to the same
grades imported from Europe. Port, grown in Cali-
fornia, is superior in purity and nutritive qualities to
any other variety we can obtain. It is almost im-
possible to obtain a pure foreign Port, except from
some old wine cellars ; and if the California Port
has a somewhat raw taste, owing to its newness, we
can vouch for its purity and be sure of its improving
by age. The clarets and hocks, and still and spark-
ling wines, which come to us not only from Califor-
nia, but in vast quantities from the immense wine
cellars of Cincinnati and Missouri, the islands in our
great lakes, and from various places in our own
State are some of them equal in flavor, and better
adapted to our own needs than those which are im-
- ported. As our wine growers become more familiar
with the most improved processes of culture and
manufacture, this country, in this department, will
rank second to none in the world, thereby enhanc-
ing the national wealth as well as health.
It would be difficult now to find wines of richer
flavor or better quality than some of those which
come to us from Pleasant Valley, and Hammonds
Port, while the sparkling wines of the Urbana Co.
are equal to the best foreign champagnes.
Of all the European countries, Italy shows the
highest yield to the acre, and yet even that country
does not come up to the California yield, within 100
per cent. Within the boundaries of California
alone, are 5,000,000 acres of land well adapted to
the grape culture ; and in the sunny valleys in
the central part of our own State, and all through
the middle States and the great West, the soil and
climate are well adapted to the growth of almost
every variety of wine.
We look forward then to the no distant day when
the judicious use among the people of the juices ex-
tracted from the fruits grown upon our own soil
will crowd out the stronger forms of alcoholic stimu-
lants, reduce the amount of crime, check the rava-
ges of disease, and make our people purer, healthier
and stronger, physically and intellectually.
Cure of Fistula Without The Knife. — Dr.
Flute cures fistula by injecting the etherial tincture
of Iodine. The ether evaporating rapidly, leaves
the walls of the fistula in contact with the pure
Iodine. There is scarcely any reaction and the pa-
tient need not stay in bed.
Prussian vital statistics show an average of 4.6
births to every marriage,
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THE TREATMENT OF SKIN DISEASES
SURGICALLY CONSIDERED.*
By William N. Guernsey, M. D.
Much, of late years, has been written concerning
diseases of the skin ; too much, one might say, as
many investigators in their desire to be thorough in
their researches, have given us the fruits of them
only, by finely subdividing classes of diseases already
known.
As a consequence, for the student of to-day, the sub-
ject of skin diseases is one of the most difficult to mas-
ter. The English school differs from the French, and
both from the German, not only in the nomencla-
ture, but also in the etiology and treatment of these
diseases. The differences of opinion do not end with
the nationality of the schools ; members of the same
school differ from each other ; and even in the path-
ology all do not coincide.
Therefore, the student usually becomes bewildered
in the maze of conflicting opinions ; and the further
he studies often plunges into a labyrinth in the
nomenclature, and so turns aside from the study of
this branch to others less obscure.
I would not therefore make any new classification
of these diseases, or of their treatment, save only for
the purpose of simplicity. With this in view, I
would consider all diseases of the skin, excepting
those of a contagious inflammatory type, from a
surgical stand-point.
Until within the past decade, little attention has
been paid to this branch of medicine in the medical
schools of our country, and even at the present time
attendance upon the lectures on dermatology is not
compulsory. As the time of study is so limited,
most of our students are so busily occupied in pur-
suing the study of the main branches of medicine, or
with preparation for the examinations, that they find
but little time to devote to extra lectures or clinics
upon any topic. Consequently, the average medical
student graduates with but vague ideas of the nature
of skin diseases, and knows but little or nothing as
to their pathology or treatment.
The fault lies not with our teachers, for most of
them have been pupils of Hebra, Hardy, and Fox,
and are able and efficient men who are thoroughly
conversant with these diseases. But the curriculum
of study is too restricted, three years is too short a
period for the student to become efficient in all the
branches of medicine. It is no wonder, then, that
the young graduate usually knowing the nomencla-
tion well, and having but little knowledge of the
pathology, should have only vague ideas of the treat-
ment, and should generally prescribe empirically and
in a routine manner.
The treatment of the diseases of the skin varies
greatly in the different European schools. The two
which have made the most thorough investigations,
and rank the highest in this department, are the Ger-
man and the English schools. The former represented
chiefly by Hebra, depend almost exclusively upon ex-
ternal treatment ; the latter, following the leadership
of Tilbury Fox, adopt the internal administration of
remedies. The Germans have had the larger clinical
experience, owing to the greater amount of material
in their hospitals at their disposal, and with them
* Read before the New York Medical Science Association.
rests the honor of making many new discoveries in
the pathology.
Of the two methods we much prefer the external ;
and that one may easily be guided- in the choice
of applications, we would regard nearly all skin dis-
eases as surgical affections, and to be treated as such.
This view presents itself, first — because it is the
more simple; second — it is suggestive as to the
proper treatment to be used ; third— it is the more
efficacious.
As surgical affections, there are three indications
as to treatment : to cleanse the diseased part, to
reduce inflammatory action, and to promote a healthy
flow of blood in the affected portion, and to remedy
any co-existing depravity of the system.
In the acute eruptive disorders there are present
the signs of inflammation, viz. : heat, discoloration,
alteration in size, modification of sensation, and dis-
turbance of the functions of the part affected.
In surgery the indications for treatment would be
to remove the cause, and to lessen the determination
of blood to the part. So the surgeon first removes
any foreign body or extraneous matter that may be
a source of irritation, and procures rest for the in-
flamed surface. Then he fulfills the second indica-
tion by the administration of diuretics, diaphoretics,
or cathartics, as they are indicated, and by the use
of local applications. These means are abstraction
of blood, cold and heat, douches, fomentations, and
sedatives.
In dermatology the same indications obtain. In
all of the acute eruptive disorders, excepting those
which are contagious, cooling and soothing applica-
tions give the most satisfactory results. These are
water dressings, powders, poultices, ointments, and
lotions, used according to surgical, indications.
The water dressings are serviceable in diminishing
the sensations of heat, burning and tension. Powders
are useful when the exudation is a source of irritation,
as in erysipelas, and where two exuding surfaces are
in opposition. They are valuable in relieving the
burning and itching in these conditions. Starch is
most commonly used; lycopodium, zinc, bismuth,
and carbonate of magnesia,
are all good.
Poultices
may be used where much swelling and tension exists.
The ointments fulfill more of the indications than any
of the others. They protect the surface from the
action of the air, render the secretions less acrid, and
when the recipient of soothing medicines, are cooling
and sedative. The benzoated oxide of zinc ointment
is almost universally used, both here and in England.
In Germany, that first used by Hebra, the unguentum
diachyli a/hi,* is commonly prescribed. It is more
soothing than the zinc ointment. Lotions are indi-
cated for relieving itching and uneasiness. Those
containing lead, soda, and hydrocyanic acid are most
used.
As Eczema is the most common of skin diseases in
this country, let us consider it first in its acute form
from our surgical premises.
Acute Eczema, according to Tilbury Fox, is an
acute catarrhal affection of the skin. It follows the
laws of catarrhal inflammation of the mucous mem-
branes. There we know it consists of an engorge-
ment of the blood vessels, accompanied by abnormal
secretion, swelling, succulency of its tissues, and a
copious generation of young cells.
* Diachylon Ointment is prepared as follows : Olei oliv., drs. xv;
Lithargyri, drs. iij et oz. vj : Coque 1. a. in ung. moll., dein adde ;
01. lavandulae, oz. ij ; M. Ft. unguentum.
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77
In acute Eczema we find an analogous condition.
The blood vessels are dilated with stasis, the follicles,
papillary layer, and superficial strata of the corium
are swollen, and these infiltrated with serum, and
filled with a great quantity of cells.
Being on the external portion of the body, we are
guided by the same rules which govern the surgeon
in treating superficial inflammations of the skin, or
the oculist in acute catarrhal conjunctivitis.
First, we remove the causes. If the source of the
irritation be due to excessive heat or cold, or to the
contact of acrid substances, the patient must avoid
them. If due to pressure of the clothing or of orna-
ments, these must be worn less tightly. If the acarus
scabei, or body lice, be the sources of irritation, these
must first be destroyed.
But these are not all the causes of Eczema The
disease may be symptomatic. It may be coincident
with dyspepsia, or chlorosis, or as it is occasionally
with rickets or scrofula.
Here internal remedies, in connection with topical
applications, seem to us advisable, although the
Germans rely upon the external treatment alone.
As the surgeon, in treating surgical diseases, aside
from using local treatment, endeavors to maintain
the normal performance of all the functions of the
body, and to remedy any depravity of the system,
so here the dermatologist should do the same. The
stomach should be made to do its duties properly;
the chlorotic girl be given iron, and the rachitic and
scrofulous cod-liver oil, in connection with the local
treatment.
The second indication, the reduction of inflam-
matory action, is met by the use of cooling and
sedative applications. In my own practice, I prefer
the use of cold water dressings, or either the benzo-
ated oxide of zinc or diachylon ointment.
Let us examine another disease under the acute
inflammatory group. As Erythema is frequently
met, let us apply our surgical views here.
Erythema consists of an inflammation of the super-
ficial layer of the corium. It is characterized by the
ordinary signs of inflammation. There is redness,
slight burning pain, and moderate serous infiltration.
As in Eczema, it is Doth idiopathic and symptomatic.
The former embracing erythema simplex, E. inter-
trigo, and E. laeve, being produced by mechanical
or external causes, require simply local treatment.
Lotions may be used to reduce heat and tension,
powders to render the secretions less irritating, and
ointment for all these purposes and to prevent fric-
tion. If the latter, the Germans als$ rely exclusively
upon external treatment. They remove all sources of
irritation, procure rest by placing the extremities in
a horizontal position, and reduce the inflammation
by the use of Goulard's extract or cold water dress-
ings.
In my own practice, aside from local treatment, I
take care that the functions of digestion and assimi-
lation are properly performed. If it occurs in a
dyspeptic, or one of a rheumatic, gouty, or lympha-
tic temperament, I prescribe medicine accordingly,
to relieve these conditions.
But I rely principally upon topical applications,
and give medicine internally, only to correct faulty
diathesis of the system.
To illustrate these views still further, let Herpes be
next examined.
Herpes belongs to the inflammatory group, as it
is an acute disease, manifesting itself by groups of
vesicles situated upon erythematously inflamed por-
tions of skin. It is characterized too, by all the signs
of inflammation : there is present pain, heat, swell-
ing, and discoloration. The microscope reveals the
same kind of pathological changes as are present in
eczema. The blood-vessels are engorged and loaded
with blood, and the cellular elements within the
papillae are increased considerably, and penetrate
the whole corium.
Herpes is usually preceded by slight febrile symp-
toms, and in most of its forms by severe neuralgic
pains. It is so often coincident with neuralgia that
they may be regarded as cause and effect. Probably
the painful irritability of the nerves produces such
nutritive disturbances, that under certain conditions
herpetic eruptions result.
Although the disease arises from internal causes,
yet the treatment is purely local. The eruption runs
a typical course, and the indications are simply to
reduce the inflammatory action, and to remove all the
sources of irritation. Hence we protect the vesicles
that they may not be ruptured by either irritation
or friction, by means of appropriate bandages, or by
layers of lint or amadon. Applications of diachylon
or zinc ointments may be used to relieve the sensa-
tions of pain and burning, and to protect the skin,
that nature may be undisturbed in its reparative
process in working a cure. If the pain be severe,
opium may be combined with the ointments. If
neuralgia be coincident, and it does not subside with
the allaying of the irritation of the eruption, the ap-
propriate remedies for it may be given.
Thus, in Herpes, as in Erythema, and acute Ec-
zema, local treatment is applied according to the
pathological indications.
As these, so may all the acute eruptions, if treated
according to the plan here indicated, become tract-
able diseases, and as satisfactory to treat as those
belonging to other departments of medicine.
In applying our views to those of the inflammatory
group which are chronic in their course, we obtain
striking results.
According to all the authorities, a majority of the
chronic eruptions, which were originally dependent
upon constitutional causes, become ultimately mere
diseases of the skin, the constitutional cause having
disappeared and the eruption remaining merely as
a local inflammation. Then the indications would
be to treat it as such, and to do it according to the
principles of surgery by treating it locally, and by
building up the general health, if impaired, and a
strict observance of hygienic rules.
In acute inflammation there is an engorgement of
the blood-vessels, a cell proliferation, and a conse-
quent succulency of the tissues. In the chronic,
other conditions are added thereto. The vascular
fluxion is not so great, yet the infiltrated cells have
undergone further development. The connective
tissue has lost its firmness and elasticity, and has
become swollen and fatty. New tissue formations,
and serous infiltrations take place, and form marked
anatomical changes.
When these conditions obtain, the indications are
to remove the causes, and to repair the effects of the
structural changes in the diseased tissues.
To meet the first, the surgeon considers the ex-
ternal influences, and the temperament of the patient ;
examines if there be any faulty dyserasia or dia-
thesis present ; and applies treatment accordingly.
The second is met by local means, and these are
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absolute rest, compression, moist, warmth, resolvents,
and derivatives.
Let us apply these indications to the treatment of
Chronic Eczema, as it is the most frequent of all
skin diseases.
Acute Eczema, we said, has been compared with
acute catarrh, so may the chronic form be considered
analogous to the chronic catarrhal inflammations.
In Acute Eczema, we had great vascularity of the
papillae, an infiltration of cells, and a pressing to the
surface of quantities of transudation liquid.
In the chronic variety the inflammatory process
has gone a step further. From the continued vas-
cularity, the papillae, which are the seat of the tufts
of blood-vessels, become enlarged, and look like
granulations. As in catarrh, these pour out a se-
cretion continually, which is either serous or purulent,
according to the degree of irritation and vascularity,
or the diathesis of the patient. From a continuance
of the irritation, the inflammation is communicated
to the deeper layers of the skin, and subcutaneous
connective tissue. Extensive cell proliferation occurs,
and these are infiltrated, and the connective tissue
bundles multiplied. Hence we have an "inflam-
matory hypertrophic" condition of the skin. It is
thickened and less supple, and has lost its distensi-
bility and elasticity. •
This chronic catarrhal inflammation of the skin is
analogous to a granulating wound surface. There
is an exact similarity in the production of young
cells by the papillary layer, in their migration and
incomplete formation ; and exactly the same con-
ditions exist between the thing secreting and the
thing secreted.
In the process of healing we have an analogous
condition in the corium to the cicatricial formations
in deeper tissues, or the healing by the second in-
tention. Although the analogue of the curative
process is perfect, yet in diseases of the skin nature
does not play so important a role as in healing by
the second intention. In these conditions much
depends upon a carefully applied local treatment.
Nature needs here to be stimulated in her reparative
action. The swollen, infiltrated, secreting, and
granular-like papillae require astringents, dessi-
cants, and resolvents. As in the reparative process
of chronic catarrhal inflammation of the mucous
membranes, under these the granulations or en-
larged papillae diminish in size, the infiltrated fluid
is returned to the mass of the blood, and the cellular
elements undergo fatty degeneration and resorption.
Springing from numerous points healthy epidermis
grows, and from these, as centers, a new skin is
speedily formed, and a cure established.
In the details of treatment, the first indication is
to cleanse the affected part. This must be done for
a two-fold reason : first, that all sources of irritation
may be removed, and second, that the medicines
applied may come in direct contact with the diseased
skin.
The crusts, scales, and scabs, must be first thor-
oughly removed. This is contrary to the doctrine
taught years since, and which, unfortunately, has its
adherents even at the present day. It was thought
that the scab formed a cover of protection, that it
excluded the air, and guarded against irritation, so
that nature might, undisturbed, form a new epider-
mal covering. The teaching was fallacious. The
crusts being dead, organic substances undergo de-
composition under the action of atmospheric air,
light, warmth, and moisture. As long as the ca-
tarrh exists the papillary layer pours out a secretion
underneath' the crusts. This moisture develops a
process of decay in these, which is a constant source
of irritation, and an obstacle in the way of cure.
Coincident with this pernicious teaching, it was also
said that the scabs should not be disturbed, as they
were the signs of the disease, and their removal would
obscure the indications for treatment. With the fuller
development of the study of pathological histology, we
derive more reliable information from the appearance
of the affected skin than from its secretions, as to
the anatomical changes it has undergone and the
treatment it requires.
Too much stress cannot be laid upon the
necessity of a thorough removal of the crusts and
scales. I have often had cases, which had seemed
to be intractable, to make a rapid recovery, where I
have attributed the failure to the fact that the
former physician had not been cognizant of the
necessity of absolutely cleansing the skin of its
secretions. I am so deeply impressed with its im-
portance, that in dispensary practice I never pre-
scribe any treatment until the patient returns to me
with the scabs and scales thoroughly removed.
The cleansing is best done with oily matters. I
direct the patient to rub the affected part with oil,
almond or cod-liver are preferable, and then to cover
it with flannels saturated with oil, and these again
with dry ones or oil silk, to be worn for twelve
hours. After this, the part is to be washed with
warm water and soap, and if the crusts cannot all
be removed, the oiling and washing are to be re-
peated until none remain.
Then if astringents are indicated, ointments con-
taining the oxide of zinc, the oxide, carbonate or
acetate of lead, or lotions of borax are useful.
The infiltrations are best relieved by empyreu-
matic oils or their derivatives, and by combinations
of potash. They all allay irritation, and have a
direct curative action.
The oils used are oleum cadini, from the juniperus
oxycedrus ; oleum fagi, from the fagus sylvaticos ;
oleum rusci, from the betula alba ; pix liquido, or
common wood tar ; coal tar or pix mineralis ; and
cosmoline, or vasoline, as it is sometimes named.
Of these, the oil of cade has been most used ; re-
cently, however, cosmoline or refined petroleum
has attracted some attention, and thus far has
given satisfactory results. Many obstinate cases
have been repdtted as cured by this new agent, and
in my own practice I have had highly gratifying
effects from its use.
The smell of tar is disagreeable to many people ;
this can be obviated in a great measure by com-
bining it with the essential oils. Newmann gives
the following elegant prescription :
Olei Rusci, i ;§; Alcohol, Ether Sulph., of each
i 3; 01. Lavandul., 01. Vertas, 01. Rosa, of each
gtt. xx. Mix.
In eczema of the hairy parts, carbolic acid is
often preferable. It is used in combination with
glycerine, alcohol and water in such proportions that
the mixture contains fifteen to twenty grains to the
ounce. Potash, in the combination of green soap,
sapo viridis, is valuable in removing infiltration.
It is to be rubbed in twice a day with flannel, and
the frictions are to be kept up until the part
becomes dry and shining. It is less irritating to
many skins than the preparations of tar, and as it
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79
is very efficacious, it may be very generally pre-
scribed in chronic eczema. As used in Hebra's
clinic in Vienna, it is made as follows :
Lixivia? Causticae Saturatae, Poudoris Specif.,
1333, fb i. ; Cetacei, fb ij. Mix.
Instead of spermaceti the potash may be com-
bined with other oily matters. I prefer it to be made
with cod-liver oil, as I think it is more efficacious,
which may, perhaps, be attributed to the action of
the iodine which it contains.
In eczema fissum, solutions of potash in water are
good. It stimulates the skin powerfully, and pro-
motes absorption of the infiltration. It is also use-
ful in the removal of the scales. I use potassa fusa in
solutions varying from two grains to a drachm to
an ounce of water, according to the extent and
density of the infiltrations. Pressure is of great
service in reducing infiltrated parts. In eczema on
the feet, legs or fingers, a cure is more quickly
attained if the salve or medicament to be used is ap-
plied by means of roller bandages, or by strapping
with adhesive plaster. Impermeable dressings are
useful on the extremities. Attention was first
called to their use and efficacy by Hardy. They
are more commonly used in eczema manuum than
in the other varieties. In this, gloves, made of
vulcanized india-rubber, or rubber cloth, are worn
continuously for .several days. The hand, being
kept warm, perspires freely, and as the secretions
are retained, the skin is macerated, and the
epidermis is removed. Hebra uses this form of
treatment extensively, and thinks the curative action
to be partly due to the sulphur which the vulcanized
rubber contains.
The dermatologist must be guided in the choice
of his applications according to the appearance and
location of the disease, and also according to the
age and sex of his patients. Children have more
sensitive skins than adults, and women more than
men.
As in the acute variety, if there be a connection
with diseases of the internal organs, internal treat-
ment should also be used. Let us examine one
more variety of this class. As Psoriasis is met
more frequently than any other of the chronic
inflammatory group, excepting chronic eczema, let
us study the indications for its successful treatment.
Psoriasis is a disease of the skin, in which there oc-
curs an inflammatory hyperplasia. This is a
chronic inflammation, occurring in circumscribed
spots. It is situated in the most superficial strata
of the corium, and in the papillary la^r. The
papillae are greatly enlarged, according to Wertheim ;
twelve to fifteen times their ordinary length, and
their vessels tortuous, and increased in both length
and size. There is an infiltration of cells in the
papillae, and in the upper layers of the corium.
According to Neumann, they are most numerous
along the walls of the vessels. There are present
the signs of inflammatory hyperaemia, swelling,
discoloration, etc. As a result there is an excessive
proliferation of epidermis cells, and in the rapidity
of this process, the systematic hardening ceases, and
in its place occurs the simple dessication of the yet
soft protoplasm. In this dessication, the cells
naturally agglutinate, and according to the size of
the accumulations the disease receives different ap-
pellations, as psoriasis punctata, psoriasis guttata,
and psoriasis nummularis. Recognizing these
pathological conditions we are governed by the
same indications for the treatment as in eczema. In
all cases we have to obtain a resolvent action to pro-
cure a resorption of the cell infiltrations. Green
soap, preparations of tar, Vlemingkx's solution, and
Rochard's ointment are to be used according to the
duration and location of the disease, and the de-
gree of infiltration. As psoriasis commonly occurs
in otherwise sound subjects, general treatment is not
usually required. Arsenic, however, has gained
the reputation of being a specific in this disease,
and may be used in connection with local means.
It acts according to the lav/ of "similia," by ex-
citing such an inflammation in the papillary layer
that the formation of scales is diminished.
Carbolic Acid, a popular remedy of late years,
acts purely mechanically. According to experi-
ments upon animals, when given in large doses it
causes anaemia of the capillaries of the skin, and so
diminishes the hyperaemia.
Want of space forbids my following out this sur-
gical view of the treatment in the other varieties of
skin diseases. I have said sufficient to show the
necessity of an intimate knowledge of their pathology,
in order that they may be treated both scientifically
and successfully. I have advocated these views, not
with the idea that skin diseases properly belong to
the province of surgery, and should be transferred
thereto, but for the purpose of showing the real
simplicity of their treatment. When properly un-
derstood they are no longer the bete noir of every
physician, but their amelioration to proper treat-
ment renders them a pleasant class of cases to treat,
as their improvement is evident to all, and the grati-
tude of the patient is usually unbounded.
EXCRETINE AND WHAT IT SUGGESTS.
By F. A. Rockwith, M. D.
Dr. F. Hinterberger'S Memoir, as communi-
cated by Prof. Hlasiwitz to the Imperial Academy of
Sciences, Oct. 10th {Nature, December 26th, 1872),
gives us additional information concerning this sub-
stance. He prepared it from fresh human excre-
ment, and found it free of sulphur, giving its for-
mula as C20 H360. It formed with Bromine Bibrom-
excretine (C20 H34 Br. 20). This contradicts Marcet
as quoted by Hoppe-Seyler (Handbuch d. Physiol,
und Patholog. Chim. A?ialys., page 230J, describ-
ing it as a crystalline body having the formula of
C78 H156 O2 S, and prepared as in the former case.
Schlossberger, however, quotes Marcet's formula as
C78 H78 SO2. It is prepared by alcoholic extraction
and precipitation with lime, and again extracted
with Alcohol and Ether, and subsequently crystal-
lized at a sufficiently low temperature. There also
exists an excretalin acid of uncertain formula — no
doubt a mere heterogeneous mixture of fatty acids.
But this finding and missing of elementary and
compound bodies in certain excretions is suggestive
and important, for it becomes necessary to establish
how far health and disease are related to this pecu-
liarity, and how far we may be guided in the selec-
tion of remedies or in the prognosis of disease by
the absence or presence of the substances in ques-
tion. For myself, I have been led to look upon the
presence of Sulphur among the excrementary pro-
ducts as a pathic element of substitution for Nitro-
8o
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gen, which, as we see above, is also missing in Ex-
cretine ; or, as a product of the decomposition of
bile, which is recognized in putrescent evacuations
under the form of sulphurous acid, Ammonium
Sulphide, and even as a metallic sulphide after the
internal administration of Mercury or Iron, but al-
ways as a bile product.
The value of observing the deficiencies or excesses
of the elements of secretion has already been de-
monstrated by the pathological facts brought to light
by the labors of those who have made the urine an
object of special study.
It has proved to be one of the most valuable aids
in diagnosis, and equally important in a therapeutic
point of view. Oppolzer has shown that in Pneu-
monia, and Ziegler that in Peritonitis, Enteritis, in-
terstitial Nephritis and Acute Pemphigus, a dimi-
nution of the chlorides in urine is indicative of a
febrile inflammatory process — especially in the exu-
dative period of croupous Pneumonia when often a
total disappearance of this element is noticed — so
that the fluctuation of the chlorides corresponds in-
versely to the fluctuations of the disease.
A similar application of this mode of diagnosis has
recently been successfully applied in Small-Pox, by
Dr. C. Hering, of Philadelphia, whoj having found
that the normal sulphocyanogen of the salivary se-
cretion was missing inversely in its ratio of appear-
ance in the pustules, gave Sinapis niger, because of
its possessing this chemical as a natural constituent,
(?) and thus corrected the mal-secretion, not, I fear,
by the laws of similars, but by isopathy.
It may be well, however, to state here that Black
Mustard does not contain Sulphocyanogen as a fixed
body, but that by a sort of catalysis or fermentation,
Sulphocyanollyl ( Cfi H5 + C2 NS3 ) is produced after
trituration and moisture, the contact-agent being
alone the normal constituent of this seed, namely,
Myrosin, an individual of the class of vegetable al-
bumenoids.
Newark, N. J.
A CURIOUS CASE OF HERMAPHRODISM.
By A. K. Gardner, M. D.
HERMAPHRODISM, so common in the many orders
of organic existence, as in plants and in the lower
forms of animal life, as the mollusca and zoophites,
has never been scientifically recognized as existing
in the higher types of being — such so called, owing
their claims to this title ato a vicious conformation
of the genital organs." This description given by
Dunglison is not exactly true, inasmuch as the sex-
ual characteristics are not confined to the genital
organs, for the general appearance of many of these
individuals as well as their interior, mental and
moral natures are marked by like discrepancies and
abnormal conjunctions. Without further prelude, I
will describe the peculiarities of an individual of this
nature, whom I saw and carefully examined yester-
day. I offer no apology for introducing it to atten-
tion, inasmuch as all such cases have a strange in-
terest to the scientific man as well as the unlettered,
and every case carefully reported is a fact ; and per-
haps from sufficient data of this character we may
find the mystery of being, somewhat cleared up, may
perhaps learn upon what depends the accident of
sex; at what period it dates ; to what degree charac-
ter is dependent upon this development; what is
the influence of education upon the mind, as crea-
ting the attributes of gentleness, modesty, timidity,
love of children, or the contrary. The case which I
shall now narrate is full of material for speculative
and imaginative research.
This child of a deceased father of Scotch birth,
lives with the mother, who was herself born in Wales,
England, and now again married, is living in hum-
ble but comfortable circumstances in this city.
The mother never noted anything abnormal or
peculiar in the conformation of the child, to whom
she gave the name of Mary. There has been noth-
ing peculiar in the condition of the child since its
birth; and until about three weeks since there has
been no thought or imagination that it was aught
else than a bright, clever girl. Over twenty years
have passed since birth, during which time Mary re-
sided at home, assisted her mother in all domes-
tic work, made shirts, sang (contralto) in a church
choir, was a favorite among the youths of the same
age of both sexes, and especially was popular among
the boys and young men. If there was a straw-ride
proposed, a party formed for any amusement, Mary's
approbation was first sought ; and if she approved —
as she generally did, being always ready for a bit of
fun — she easily enlisted. the girls around to join.
Among all she was especially distinguished for mod-
est behavior, allowing no liberties, and was much
"averse to being kissed by any of the fellows," an
attempt frequently made.
The only trouble that her mother felt was, that
she did not menstruate, and she made frequent
efforts to bring on her periods by emmenagogue
medicines, and finally insisted upon her submitting
to a physical examination. Greatly against her will,
she at last went to the family physician, Dr. C. E.
Campbell, and subsequently he brought her to my
office, and the examination revealed the following
extraordinary facts :
Mary is about 5 feet 5 inches in height, of
a spare frame, and with little in her general appear-
ance, remarkable. She has however, some hair
upon her upper lip, but not more than occasionally
seen in women, with a few scattering hairs upon her
chin, and these probably increased by having shaved
them off several times. This hirsute condition has
been noticed only about a year and a-half, about
which time her voice changed to a baser tone, iden-
tical to ^hat noticed in boys whose voice is taking a
baritone character. Her figure is lithe and active,
with hips less marked than is usual in females.
Her legs and arms are less rotund than in females, and
her legs remarkably masculine in form. The breasts
are protuberant, and the right has an especial mam-
mal development, the gland formation being mark-
edly present. There is, however, no nipple, and
with the areola resembles rather this part of the male
formation. The mons veneris is covered with a
thick growth of hair which, however, does not ex-
tend downward upon the annexed labia. The labia
majora are unusually protuberant, reported to be
owing to the irritation of the recent examinations.
On separating these lips, a marked hymen is observ-
ed, crescentic in shape, and occluding the lower por-
tion of the vulva, but not preventing the entrance of
the finger almost to its full length, when it touches
the end of this cul-de-sac, at the extremity of which
the passage abruptly stops ; and no examination
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81
per vagina, per rectum, or above the pubis can dis-
cover any uterus or ovaries. There is, however, a
feeling of thickness, as of a firmer tissue, or redu-
plication of membrane, at the extremity of this
pouch, such as one might imagine would be given,
were the womb extirpated, by the cicatrix of an un-
defined inflammatory action.
In the place where the clitoris should, be found,
there is an evident penis formation, composed of a
corpus cavernosa, which possesses some power of
erection — said to have never been noticed till since
the repeated examinations. The glans penis is marked
in its shape, and the whole organ when at its full-
ness is about three inches long. The corpus spongio-
sum is apparently wanting, as the organ is imperfo-
rate— the meatus urinar?usQ-ad'mgim.media.tely at the
base of this organ. The prepuce is evidently a con-
tinuation of the labia minora from each side, con-
tinuing along the side of the organ as a fringe and
not uniting beneath.
The fullness of the labia majora, already spoken
of, is accounted for by the fact that movable, globular
bodies are apparent in each. That on the right side
is far the largest, and is in consistency and "feel"
such that one has but little difficulty in recognizing
it as a testicle.
In all this manipulation, Mary states that there is
no sensation apparent, except smarting; but there
was at times a marked erection of the penis and
spasmodic contractions upon the finger when intro-
duced within the vagina.
We have few cases of "miscegenation" (to use
Sweetzer's coined word in a somewhat strained
sense) more marked than this. The question is to-
day, to which sex does this person belong? The
presence of the testicles, although impotent, practi-
cally might give the weight of evidence to the mascu-
line side of the question, but the tonic influence thence
derived, is more than neutralized by the feminine life
of more than twenty years.
Some anomalies in the character, both mental and
moral, must necessarily be observable in a person so
sexually constituted. Incapable of perpetuating the
species, the endearing situation of husband or wife,
father or mother, are alike debarred ; but the pure
consolations of friendship and platonic love are open
with all their charms. Unhappy will it be, indeed,
should inducements to a change of habits and life be
accepted, which should draw this person from the
privacy of domestic life into a public career, sup-
ported by the exhibition of a deformed person to
the curious gaze — even if limited to the medical
profession — of those who would see without sym-
pathy, and thus commence a life which must end
in demoralization and. regret.
So far as my advice could go, it would be that a
veil of forgetfulness be brought to cover the last few
weeks of feverish anxiety, and that in the future, the
serene repose that belongs to the domestic circle,
the soothing influences of healthy employment,
music and books, may bring perhaps as much hap-
piness as usual on earth, and be fit preparation for
that land "where there is neither marrying nor
giving in marriage, but where all are as the children
of God."
THE APPROPRIATION OF HOMCEOPATHY BY
THE OLD SCHOOL.
By J. N. Tilden, M. D.
N. Y,\ 237 East i^tk St., April \Mh, 1873.
Minnesota crows over Massachusetts with an
annual birth-rate of 30 per diem.
The perusal of " Ringer's Hand-book of Thera-
peutics," a recent and very popular allopathic work,
brings most vividly to mind the remarkable incon-
sistency and assurance of the " regulars," in appro-
priating the results of Homoeopathic labor without
any compunction or disposition to give acknowledg-
ment therefor.
The old adage of " Honor to whom honor is due,"
seems to have been entirely ignored by the author of
the above work, for he very coolly goes on to recom-
mend medicines, in small doses and for precisely the
same conditions of disease, for which they have been
used by Homoeopaths since Hahnemann first taught
the doctrine of "Similia."
Let us look at a few instances. On pages 190 and
191, speaking of arsenic, the author recommends it,
in one or two drop doses of Fowler's solution, for
various affections of the digestive organs — vomiting,
chronic ulcer, cancer of stomach, diarrhoea and
cholera. Again, in treating of the therapeutic prop-
erties of creosote, it is regarded as an admirable
remedy for nausea — and to quote directly a sen-
tence, which would not be amiss in a Homoeopathic
Materia Medica — "the author believes that the
failure of the remedy to check vomiting, in many
cases, is owing to the largeness of the dose that is
given, and which often itself produces these symp-
toms if administered in such large quantities.
"'The best effects are obtained if just sufficient
creosote is added to water to make it taste distinctly,
but not strongly, of the medicine."
Is " the author " aware that he is here plainly ad-
vocating the truths which ■ lie at the foundation of
Homoeopathy — that system of medicine which is
claimed by allopathic authority to be wholly expect-
ant and inert ? We would fain have enough faith
in humanity to believe that he sins ignorantly, in
thus appropriating the property of others.
A few more striking illustrations we find as fol-
lows : Cantharides in acute Bright's disease, and
other affections of the urinary organs, is recom-
mended, as well as Camphor for summer diarrhoea
and cholera. Ipecacuanha in drop doses of the wine,
for vomiting, etc. Belladonna for diseases of the
throat, whooping cough, headache — a preventive also
for scarlet fever. Veratrum Alb. for summer diar-
rhoea. Aconite is spoken of in the following language :
" It is on account of its power to control inflammation
and subdue the accompanying fever that Aconite is
to be most esteemed. The power of this drug over
inflammation is little less than marvelous."
These examples cited are not exhaustive, but are
casually selected in hastily looking over the pages of
this modem Therapeutics.
While it is encouraging to find that the "old
school " is progressing toward a more rational and
humane medication, we would like them, as mem-
bers of a philanthropic profession, to show honesty of
purpose sufficient to acknowledge the fact, when they
do use a medicine according to our law — our guide.
It certainly gives us just cause for complaint, that
while they affect to deride and despise our system
of medicine, they are every day practically employ-
ing it as a means for curing disease.
Peekskill, N. Y.
82
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SOME THOUGHTS ON UTERINE DISEASES.
By A. K. Gardner, M. D.
No. I.
Uterine disease, as v/e now understand this
term, dates from the re-discovery, if not, in fact,
the re-use of the speculum by Recamier. There
were, indeed, certain grand lesions of the womb,
and the passages to and from it, such as were easily
recognizable by the finger, such as polypi, large
tumors, cancers, etc. ; but of those minor ills, in
appearance, slight displacements, minute fungus
growth, epithetial abrasions, deeper ulcerations,
uterine engorgements, cervical catarrh, endo-metri-
tis, cervical metritis, and indurations, resulting from
inflammation, and hosts of slighted ills, now tabu-
lated and classified, nothing was known. The
gynecologist of those days treated green sickness
and leucorrhcea as diseases, instead of symptoms of
some general or local disturbance, and multitudes
of women, with miserable days and nights of suffer-
ing, wore out life, treated for liver-complaint, wast-
ing sickness, or cancer, thus exhausting the science
of the day. Indeed there now originated the dis-
tich—
"Affliction sore long time she bore,
Physicians tried in vain."
But the light thrown by the speculum upon these
obscure diseases was the beginning of an unending-
era of reform and relief, but not without many de-
lays and no little opposition. Physicians were slow
to recognize the ulcerations of the os uteri as evi-
dence of disease, or to trace any connection between
such like trivial disorganizations and the nervous
debilities, physical prostrations, and general good-
for-nothingness of their possessors. Even men of
such high intelligence as Dr. John W. Francis were
long incredulous. Untaught in younger days, they
went through the form of examination — generally,
indeed, so clumsily, and with such a parade of deli-
cacy and over-care, as to disgust alike themselves
and their patients, without attaining to any result.
Indeed, not unfrequently, a half hour was fruitlessly
spent without succeeding in bringing the os uteri
into view.
In this country " Bennett on the Uterus" was
the spectacles by which every one saw, and his
treatment with nitrate of silver the only method of
cure known. The zeal of proselytes is as recog-
nizable in medicine as in everything else. Every
practitioner strove to outdo his teachers, and new
and more potent caustics were invented or brought
to bear in this new "direction, and the acid, nitrate
of mercury, potassa fusa, and even the actual cau-
tery, were in daily use by men as ignorant in the
pathology of the diseases treated as rash in their
therapeutics. Indeed, a man most distinguished in
his day, and one of the host of great medical men
of modern Europe, Lixfrarc, published accounts of
scores of uterine cervical cancer cured by amputa-
tion of the os uteri — a claim which, had he lived
longer, he would have been compelled to renounce.
Nor has the extravagance in the claims of uterine
specialists diminished with advancing years. The
actual cautery gave way to the galvanic cautery,
and this to actual amputation, as sponge tents gave
way to " slittings-up " of the cervical canal, and re-
movals of "wedge-like" portions. Pessaries have
been ignored by all of any therapeutical lore. But
still uterine surgery and uterine fees have markedly
increased, and ladies are as proud to be seen in the
anteroom of a fashionable specialist as in the boxes
of the opera-house.
What is the result — quackery in its worst, be-
cause concealed, form. Diseases are re-baptized
with new and formidable sounding names ; unnec-
essary treatment is made, operations constantly
done which are totally uncalled for, in the hospitals
and cliniques for show, and in private practice for
lucre. Many more visits are made than are neces-
sary. I have seen childless women, of small
means, with nothing more than slight cervical me-
tritis, who have for six months made daily visits at
$3 each to a gynecologist for topical treatment, and
many for slight epithetial abrasions having three
vaginal explorations and treatment every week for
many months. I maintain that no Hippocratic oath,
even in Tweed times, can stand such a tax.
A lady came to me from the West desirous of
children, in the vigor of health, aet. 35. On exam-
ination I told her she was singularly free from all
disease, but that there was a slight but recognizable
stricture of the cervical canal, which might by. a se-
rious operation be treated, but I was greatly afraid
with no change in her condition of sterility, and
really advised her not to undertake to interfere with
it. But she went to Europe, came into the vortex
of a fashionable gynecologist, had the canal divided
with the knife, lay some three months on her back,
paid $500 for the operation, and as much more for
subsequent visits and treatment. Result — a constant
pain in the sciatic nerve of one leg for over a year,
and now, after some years have elapsed, no children.
This operation was done for money, not for the pa-
tient's best interests, and I call it quackery; but
they don't suspend members of the academy for
such a violation of their code of ethics.
* $ * # *- *
Now what is the lesson of to-day? I shall not
occupy space to make logical deductions, but I will
state my opinion briefly upon some points of a gen-
eral nature :
1. Uterine Diseases are Over-treated. —
The diagnosis should be more minute and definite,
and the local treatment directed solely to the origi-
nal disease, and less to concomitant and resulting
symptoms.
2. The local applications should be generally of
a milder nature than those commonly employed.
3. Such local applications should be made less
frequently than is ordinary, generally not more
than three times a month, and in extremely rare
cases not oftener than five days.
4. Far more attention should be given to the
general treatment ; and it should be remembered,
what has been generally ignored, that the uterus is
part of the system, and not a separate body, and
that its diseases are amenable and often curable
solely by remedies applied to the general constitu-
tion.
5. Experience has also taught the inutility of
the powerful caustics and escarotics formerly alone
used, and even now far too frequently employed
by practitioners whose learning is of the past. In
my own practice the use of nitrate of silver, even, is
the exception rather than the rule ; the milder and
less irritating applications of the sulphates of copper
and iron and tannin locally applied, I find to be
The Medical Union.
83
followed by less subsequent irritation and speedier
cure; especially when combined with appropriate
general remedies which, formerly, I almost entirely
neglected.
6. In the use of astringent vaginal injections I
find little benefit, mainly because they do but very
imperfectly touch the diseased part, and their effects
upon the healthy vagina are decidedly injurious; and
particularly alum is markedly irritating and espe-
cially objectionable. An infusion of red-rose leaves
or ordinary green tea (hyson) is adequate to all the
necessities in this direction. Even very cold water,
in which I once had great confidence from a theo-
retical idea, I now entirely dispense with, preferring
tepid water to cleanse the parts, which is not fol-
lowed by very injurious reaction. Especially is cold
water injurious after sexual connection. I have
known many cases of uterine congestion and ca-
tarrh, and various concomitant troubles to which
I could trace no other cause than this indiscreet
bathing of the parts when hyperstimulated and
congested by natural causes. All the desired re-
sults could have been as effectually obtained by
water whose temperature would not have been per-
ceptible, and which would not have thus suddenly
arrested the exhalations from the mucous secret-
ing glands which stud this passage.
A LETTER FROM JOHN CRANNELL.
" But we confess to some doubt as to the meaning
of ' John Crannell,' on page 11, where he says,
' if one school becomes contemptible on account of
intolerance and bigotry, and another school be-
comes absurd from the ignorance and credulity of
its members,' etc., etc. Can he mean to consti-
tute himself ' autocrat of the editors' table,' and dis-
pense general condemnation as a patent cement for
disunited doctors ? And does he wish to say, that,
as the allopaths are intolerant and bigoted, the ho-
moeopaths are ignorant and credulous? What is
the use, then, of trying to cement them, or form a
medical union ? Is it to found a third or new eclec-
tic school? The wise ones must, of course, all
flock to its standard."
So writes Dr. J. C. Morgan, of Philadelphia, in
the March number of the American Journal of Ho-
moeopathic Materia Medica. The Doctor will per-
haps agree with me when I express the opinion that
no school can lay claim to all the intolerance and
bigotry that exists among doctors, and that ignor-
ance and credulity are too often met with in all
schools. I cannot acquit one doctor from the
charge of intolerance or ignorance on the ground
that he is a homoeopath, any "more than I can as-
sume that because another doctor is an allopath he
is necessarily fit for the kingdom of heaven. The
Doctor mistakes my meaning if he supposes that I
consider all doctors as either ignorant or intolerant.
A small but active minority in both schools may be
fairly classed as such, and the very activity of their
intolerance multiplies itself to the disadvantage of
a liberal majority, just as a very little mud can make
a very large splash. I, for one, do not seek to
unite physicians, belonging to different schools of
medicine, on any therapeutic platform. It is not
proposed to amalgamate homoeopathy and allopathy
in the practice of medicine, nor to build up a new
sect on the eclectic plan. The union for which I
hope is one that will allow every physician to use
whatever remedies and follow whatever treatment
may seem in his judgment best adapted to the
cure of his patients, without thereby subjecting
himself to professional ostracism. In a word, I
would make a thorough medical education the
necessary qualification of every physician for the
practice of medicine, and take it for granted that
a diploma that can be accepted as a guarantee
of such an education must also be accepted as evi-
dence that its possessor should be trusted to use his
own judgment in medical matters, without in-
terference directly or indirectly from any code of
ethics. And if in accordance with this plan, one
chooses the old school and another the new school,
while a third finds much that is good in both — very
good, let each one cure his patients in the way that
seems to him best. Although he may practice allo-
pathy, or homoeopathy, he is none the less a physi-
cian, and as such he occupies a higher ground, a
broader field, than as a merely sectarian follower.
On that higher ground I would put the basis of
medical union. Such was the spirit of the distin-
guished pathologist, Tessier, whose words should
ever be remembered :
" Yes, we refuse, and always shall refuse, the ap-
pellation of homceopathists, because we are as ad-
verse to the sectarian spirit as we are devoted to
truth. We admit to be true the therapeutic
system, invented and developed by the genius and
immense labor of Hahnemann ) but just as we ad-
here to the psychology and physiology of St.
Thomas, without calling ourselves Thomists ; just
as we profess the doctrine of the essentiality of dis-
eases, without calling ourselves essentialists ; just as
we cultivate, and have always cultivated, pathologi-
cal anatomy, without calling ourselves anatomical
pathologists ; just as we employ auscultation and
percussion, without calling ourselves auscultators
and percussors ; just as we devote ourselves to clini-
cal observation, without calling ourselves observing
physicians ; just as we study general medicine,
without calling ourselves theoretic doctors, so we
neither desire nor admit the appellation homoeo-
pathic, applied either to ourselves or our labors.
We are physicians, and our work is to perfect the
art of medicine, We admit homoeopathy, because
it is a great truth in therapeutics, and we reject it
in the character of a medical doctrine."
In the early periods of Egyptian history we learn
(Diodorus Sic, Lib. I, cap. 28) that instead of pre-
scribing medicines according to the judgment and
experience of the practitioner, every physician was
obliged to follow a written code ; and if, in adhering
to this, he proved unsuccessful, he was free from
blame ; but, if he ventured to depart from the pre-
scribed forms, though the patient recovered, the
physician was to lose his life. Now, he only loses
his seat in the Academy of Medicine and retains
his life, which is supposed to be a burden to him
forever after. Such is the venerable spirit dis-
played by some among the old school. As to the
same intolerance among the followers of Hahne-
mann, I need only refer to a letter from the pen of
Adolph Lippe, that lately appeared in the Evening
Bulletin, of Philadelphia. And just here may I
ask the indulgence of the reader while I make a
slight digression.
The New York Times, without any solicitation on
the part of this journal, very kindly noticed the first
84
The Medical Union.
appearance of the Medical Union in an editorial,
commending, in its own words and way, the broad
and liberal position of the new journal. This edi-
torial having been copied into the Philadelphia
Evening Bulletin, aroused the wrath of Adolph
Lippe, a homceopathist of that city, who forthwith
seized his pen and thus addressed the public :
* The Times has evidently
been induced to publish that objectionable article
by a misrepresentation of facts made to it by the
editors of a new medical journal, advertising itself
and its editors thereby. Permit me to point out a
few of the many misstatements made in said article,
correct them, and show the fallacy and inconsistency
of the position assumed by the Medical Union,
the advertising journal," and so on, ad nauseam.
As the editors of the New York Times are alone re-
sponsible for the article, I leave them to utter de-
struction at the hands of Lippe. My digression is
not for the purpose of interrupting the harmless
amusement of one who builds a man of straw in or-
der to knock it down again, nor is it necessary for
the editors of the Medical. Union to deny that
they have misrepresented facts for the purpose of
advertising themselves and their journal, since Dr.
Lippe's assertion is sufficient to render a denial su-
perfluous. When I consider how difficult it is to
teach an old dog new tricks, I can even pass over
the impudence and intolerance of the man, and ex-
ercise an amount of resignation for which I claim
no patent, since virtue is its own reward. But no
punishment can be too severe for one who attempts
to do sharp work with du]l weapons. When Dr.
Lippe wishes to attack the Medical Union again,
let me implore him to do so with more skill. Such
blundering work is harrowing to every sensitive
mind. As an example, which the Doctor may ponder
upon, I tender him my compliments and my opinion
in an epitaph. And lest he should be tempted to
die at once in order to have it upon his tombstone,
I can assure him that it will apply equally well to him
living or dead. It is, in fact, a portable epitaph,
since, wherever he is, it will not be out of place.
He can take it to bed with him at night. He can
have it engraved on his seal and stamp all the pro-
ductions of his pen with it. Nothing could be
more appropriate than to have it appended to the
article I have referred to above. What epitaph
can be more touching ! more true !
Here lies Adolph Lippe.
It can hardly be necessary for me to offer to the
Doctor the renewed assurances of my distinguished
consideration.
To resume. Patrick Henry, as every school-boy
orator is doubtless aware, knew of no way of judg-
ing of the future but by the past, and that seems to
me to be a very rational basis for prophecy in
medical matters. In taking a retrospect of the
medical world from the time of the great-grand-
fathers of our art, we are impressed with the fact
that medicine repeats itself. There is a steady ave-
rage of intolerance and ignorance, unalterable as
the laws of the Medes and Persians, that may al-
ways be depended upon in the future, if the past is
any criterion. The hepatic viscera of the medical
profession to-day is just as productive of choler as
in the time of Homer, when temper and bile were
synonymous. We cannot expect, therefore, that
any plan contemplating the union of harmonious
elements in the profession will escape the opposition
of the elements that are discordant. The allopath
who considers that a pure medicine and undefined
requires a tea-spoonful of calomel and forty-grain
doses of quinine for the cure of intermittent fever,
will meet a foeman worthy of his steel in the ho-
moeopath whose study of symptoms and strict ad-
herence to the doctrine of Hahnemann leads him
to rashly expose his patient to the aggravating ac-
tion of the forty- thousandth trituration of a pulver-
ized bed-bug. Let them arrange their little differ-
ences between themselves, our part is simply to
look on, with the hope that when the lion and the
lamb lie down together, we may be there to see it.
,Our work lies in a different field. We seek to
make the ability and education of a physician the
only tests of his fitness to enjoy every position and
every honor within the reach of his profession. We
claim that, when by a thorough and complete edu-
cation he is made conversant with all the technical
details of his profession, he acquires the right to
think for himself and to act upon his convictions
without being expelled from medical societies or
outlawed by a code of ethics. If this is illogical,
then I must be content to prefer what is right to
what is logical. John Crannell.
Massachusetts Medical Society vs. The
Homoeopaths. — The injunction against the Massa-
chusetts Medical Society was dissolved last month
on the ground that the court that issued it had no
jurisdiction in the case. This virtually ends the
matter, and leaves the Society free to discipline its
members. It is a sad commentary on the condition
of the Society that its members are not sufficiently
intelligent to judge for themselves as to what is
right. Massachusetts, that boasts so much of her
educational advantages, should have a corps of phy-
sicians who are individually able to discipline them-
selves.
Brooklyn Homoeopathic Lying-in Asylum.
— The lady managers of this institution have estab-
lished a nursery in connection with the Asylum dur-
ing the past month. Rooms in the building at
present occupied by them have been newly fitted,
a dozen cradles have been prettily furnished, and
most of them already supplied with babies. This
department has been greatly needed, and the ladies
congratulate themselves upon its auspicious com-
mencement. Next month they propose to estab-
lish a school for nurses. This department of the
institution has been talked of for a long time, and is
now in a fair way to be realized. The physicians of
the institution have nearly completed the plan for
instruction, and hope soon to develop it. We can
only say now that the •history of all similar institu-
tions at home and abroad is being carefully studied,
and it is hoped to make the school a success. Dr.
Varona has resigned his position as Resident Physi-
cian and Surgeon, and taken private offices on Clin-
ton Street. His rapidly increasing surgical practice
rendered the step necessary. The ladies received
his resignation with regret, and passed a compli-
mentary resolution in accepting it. He is succeeded
by J. F. Oaks, M. D., from Rochester. Dr. Oaks
is a graduate of the College of Physicians and Sur-
geons, of this city, and brings with him a reputation
for surgery and an experience in the hospitals of his
native city which will be quite valuable to him in his
new position.
The Medical Union.
85
The Medical Union
A MONTHLY JOURNAL
Of Medicine, Surgery, and the Collateral Sciences.
Editors :
EGBERT GUERNSEY, M.D. CHARLES E. BLUMENTHAL, M.D.LL.D.
JOHN G. MINOR, M.D. ALBERT E. SUMNER, M.D.
H. M. PAINE, M.D.
Published on the First of each Month, by
C. T. HURLBURT, 898 Broadway, New York.
NEW -YORK, APRIL, 1873.
"A iregular medical education furnishes the only presumptive
evidence of professional abilities and acquirements, and ought to be
the only acknowledged right of an individual to the exercise and
honors of his profession." Code of Medical Ethics, Amer. Med.
Ass., Art. iv, Sec. i.
PHYSICAL DEVELOPMENT.
When Charles Reade, in a recent novel, aimed a
trenchant blow at one of the idols of the people,
and attempted to show that such severe physical
training as was practised by Geoffrey Delamaine in
preparing for the race, was liable to break down the
physical system and prepare the way for an early
death, it produced more ' than ordinary interest
and excitement. Athletic sports are the pride of the
English people — rowing, running, boxing, leaping,
and the various sports of the field are considered a
part of every gentleman's education. The students
from our own colleges, until quite recently, on visit-
ing England found themselves able to construe Latin
and Greek with the best of the graduates of. Oxford
and Cambridge, but in physical training they were
nowhere. The Englishman came out of his Univer-
sity not only with his mind richly stored with science
and literature, but with a physical training which
enabled him put in practice on the great field
of life, the lessons he had been taught. With the
American, on the contrary, everything was sacri-
ficed to the intellect; and the poor boy often left
his college halls with a constitution broken by hard
study, and a total disregard of physical health.
That, however, is now being rapidly changed, and
our American colleges encourage those manly sports
which contribute so much to physical development
and health, both of body and mind. There is no
doubt that exercise may be too violent, and the sys-
tem permanently injured by overstraining, notwith-
standing a distinguished English student has at-
tempted to prove the falsity of the position taken by
Mr. Reade, by showing from statistics that those who
are most distinguished in Oxford and Cambridge for
athletic sports, have been the longest-lived. It is
undoubtedly true that in our large cities, and in
persons engaged in sedentary occupations, in both
sexes, many an ache and pain and very many severe
attacks of sickness could be avoided if the circula-
tion were kept active in all parts of the system
through judicious exercise. The man of business
could often dispense with his Congress water and
gout pills ; the professional man would find his di-
gestion better, and his brain clearer and more ac-
tive, and our wives and sisters could go through the
vexatious routine of their cares with less danger of
breaking down. It is true, with a little more at-
tention on the part of our patients to that form of
exercise which would keep up a healthy circulation
In all parts of the system, our bills would sensibly
decrease, but then only think of the satisfaction in
treating patients whose powers of reaction would be
strong and active when sick, and from whose treat-
ment then, some little professional credit could be
derived. Oliver Wendell Holmes remarks in one
of his oracular sayings, "During exercise the mus-
cles want blood, and suck it up like so many
sponges." But if one portion of the body receives
more than its proper share of exercise, there is often
a deficiency of strength in some other portion of the
system. Among the many contrivances to develop
the physical system and equalize the circulation,
none seem to us more thoroughly scientific and bet-
ter adapted to accomplish the purpose than the
"Health-Lift." It not only reaches a class of cases
we find most difficult to touch with the ordinary
forms of medication, but is a material aid to us in
treating forms of physical weakness, such as pro-
lapsus of the womb, where we need something
more than mere drugs to produce a cure. We have
often felt its beneficial effects in our own persons,
and have repeatedly seen its healthy action in
others.
VACATIONS FOR DOCTORS.
An eminent physician of this city used to tell his
patients that he hardly earned his bread and butter
till after all his teeth were gone, so that he could not
enjoy it. The good old man has long since gone to
his rest, but the truth of his saying lives yet in the
experience of many physicians. No class of men are
so completely subject to the necessities and whims
of others, and none are so constantly overworked,
as doctors of medicine. The man of business can
leave his business in his store or office and use his
evenings as he chooses, and when he retires at night
his rest is undisturbed except by the casual burglar
or an accidental colic. The lawyer attends to his
clients during certain hours in the day, and if he oc-
cupies himself with legal studies in the evening, it is
only from an occasional and voluntary desire on his
own part. His professional duties rarely prevent
him from six hours of recreation daily if he wishes
it, and his sleep at night is as easy and undisturbed
86
The Medical Union.
as the nature of his profession will allow. The
clergyman also has certain hours for piety and busi-
ness, and the brain and body are at rest during the
night. But the doctor has no time he can call his
own. His own inclinations and comfort are never
consulted by those who need his services at mid-
night. The merchant's stomach may require to be
pacified in its rebellion against too much salad, and
forthwith the doctor must come out of his warm bed,
every bone and muscle aching with a long day's
work, and attend the patient, with an alacrity which
is supposed to be cheerful — and when the doctor
comes back again and has been duly lectured by
his worthy spouse for coming to bed with such cold
feet, he sinks into the sleep whose innocence only
children and doctors know, but only to be wakened
again by a hasty summons to repair at once to the
lawyer whose conscience is more active than usual
and whose sleep is therefore disturbed, or to the
clergyman whose liver, after disturbing the minds
of his congregation, is now disturbing the body of
its owner. And then again there are the babies —
God bless them — who are sure to begin life at some
inconvenient hour of the night, when the daytime
would do just as well; who make a habit, the little
rascals, of putting off their little colics and other ne-
cessities of infantile existence, till after the doctor has
gone to bed, or, at least, they will seize some equally
inconvenient time when the doctor has promised his
wife and children that he will accompany them to
some long-promised entertainment.
Now all these occurrences are right enough in
their way and no doctor will complain of them, for
it is his business to do just that kind of work, and
to do it at all times, consulting not his own conveni-
ence but the necessities of his patients. But when
we consider that the older a physician becomes and
the more successful he is, the harder he is worked,
and that when he most needs an occasional relaxa-
tion from his labors he is unable to obtain it, we be-
lieve that an innovation is warranted. We advocate
vacations for doctors. Young doctors, beginners in
the profession, can afford to work all the year round,
for their time is more abundant than their money,
and their practice is not so firmly established that
they can wisely leave it to the chance of going astray.
But the family physicians, on the heaven-side of fifty,
should certainly take a vacation during the heated
term of midsummer. No class of men deserve or need
it more and but few are so poor as to be unable to
do it. Doctors are subject to the same ills that af-
flict other mortals, and they should take the same
remedies they prescribe for their patients. A vaca-
tion once a year is as necessary for an overworked
doctor as a Sunday's rest is for a stage-horse. At
least a month should be spent away from the city,
and how this is to be accomplished we leave to the
doctor's ingenuity. Half the pleasure of a vaca-
tion is in the planning of it, and we should like to
suggest many things which want of space obliges us
to omit. How delightful it would be for the worn-
out family physician to leave his pills behind him
and stretch his attenuated legs over the green fields
of the country. How healthful and invigorating,
with gun in hand, to pursue the gregarious sparrow
as he sits upon the telegraph wire, or to lie in wait
for the devastating woodchuck. What can be more
conducive to the recuperation of the anxious mind
than to recline, sub tegmine fagi, on the mossy bank
of some gentle stream while he impales the peris-
taltic worm upon the jagged hook and entices the
unsuspicious bull-head to an early death. But
enough, a word to the wise is sufficient.
INSANITY.
A GENTLEMAN, some years since, in going through
a lunatic asylum amused himself by asking some of
the less violent why they were there. Different
reasons were assigned without admitting the true
cause of their confinement. At length the ques-
tion was asked of one who, walking quietly about
the grounds, showed to the casual observer no ex-
ternal signs of insanity. " Simply for a slight dif-
ference of opinion," was the reply. " I insisted
that the world was out of tune, disorganized, in fact
insane ; while the world declared it was I who was
insane, and, having the power, shut me up here I
am the victim of a very great injustice, sir, as you
perceive ; but what can I do but to suffer the mar-
tyrdom which has ever been the lot of those who
have proclaimed unwelcome truths."
There is a good deal of truth in the remark of
the lunatic. The world is, more or less, a crazy
world. You can hardly find a man or woman who
is not, to a certain extent, a monomaniac upon some
subject. With one, it is pride of birth, a venera-
tion for ancestry which may be traced way back into
the dark ages, but whose great virtues, if there ever
were any, their descendants have failed to imitate.
With another, it is a narrow bigotry and intolerance,
breathing out anathemas upon all who dare assert
the right of independent judgment, and who insist
upon forming their own conclusions and deductions
from experience and well-established facts. Cour-
teous, friendly and gentlemanly when every thing
runs smoothly, you have only to controvert their
theories or show a leaning toward some hated rival,
to bring out a growl which startles you with its fierce-
ness. There is always one word which will make
the eye flash, and develop the latent insanity. To
the orthodox theologian it may be the name
of some sect which he believes has wandered away
from the fold and is perverting the truth ; while the
The Medical Union.
87
other party glory in persecution, and hug close
the crown of martyrdom. Among medical men,
the mania develops itself in strange and curious
forms. To the orthodox allopath, deep dyed in the
wool, the very name of homoeopathy almost brings
on an attack of hydrophobia. He snaps out his
words with a bitterness, and his tongue wags with a
venom which astonishes you. Courteous and polite
in his intercourse with his fellow-men, you have
only to breathe this word, and every gentlemanly,
Christian instincts in his nature seems to be obliter-
ated. On this one subject the man is absolutely
insane. Gentlemanly courtesy is forgotten, and
though his pockets may be stuffed with tracts to
deal out to his patients, the very elementary princi-
ples of the religion he professes to love is lost sight
of. Another is so wrapped in the mantle of his
own conceit, that he looks in lordly scorn upon the
opinions of others. In his own estimation, he is the
largest pattern of a man the Almighty ever. made.
In his little brain is concentrated the wisdom of the
past and the present. His tremendous mind has
fathomed all the' depths of science and established
rules and laws of medical practice, the correctness
of which it is heresy to doubt. This is his insanity.
He forgets the truly wise man is modest ; that the
field of medical science has not been so thoroughly
tilled as to develop all its richness ; that there may
be mines of wealth there which have never yet
been brought to light, and that other plans of de-
velopment than those which he has practiced, may
yet bring forth grand results. This kind of insani-
ty is often seen in those whose experience is confined
to a few years ; who have just launched their barks
upon that vast ocean upon which others have sailed
and watched its tides and currents, its rocks and
hidden dangers, and studied it, in all its fitful
moods, until their heads were gray with age. Some
day a riper experience, more careful study, and that
kind of rough handling which theoretical men are
likely to get, when brought in actual contact with
danger, may soften the disagreeable phase of their
insanity, and teach them a larger wisdom and a
broader charity.
There is another form of insanity often seen
among medical men, but always found in narrow
minds and ignoble natures. It is that envious and
jealous spirit which seeks to magnify its own im-
portance and build up its own reputation by pulling
down those of others. With the exception of some
few of their own particular set, you never hear from
them a kindly word of brethren in the profession,
but always find them ready with their censorious re-
marks and sneering words. As this is one of the
lowest forms of the kind of insanity of which we are
speaking, it is the most dangerous. However des-
picable they may be in themselves, and in however
little estimation they are held by the public, still,
the falsehoods and slanders which drop so readily
from their tongues, passed from one to another,
may at length, when their origin is unknown, be
looked upon as truth.
Our profession, which of all others should have
the broadest charity for the failings of the v/orld,
and which, with properly directed efforts, can do
more than any other to elevate the human race,
should scrutinize with more than ordinary care their
own motives, and look carefully into their own
^hearts, lest the teachings of their lips are more than
counteracted by the example of their lives. The
example of that great physician whose life was a
mission of love, and whose golden maxims, if rightly
followed would sweep away all these forms of in-
sanity, should become a part of our very lives.
HOMCEOPATHY IN THE MICHIGAN
UNIVERSITY.
By a recent act of the Legislature of Michigan,
two professors of homoeopathy are to be added to the
medical faculty of the Michigan University. The
result of this measure will be regarded with the
greatest interest by the physicians of both schools
at home and abroad. At once we have this great
question settled — and we hope forever — that one
medical school cannot exclude another from all the
positions of professional honor and trust in our pub-
lic institutions. Doubtless the merits of the question
present themselves to most physicians, on the ground
of a direct issue between the merits of the two
schools. To us, this view is not the one which will
most repay our consideration. It is true enough
that the two schools must fight out their battles by
actual demonstration in private and public practice,
so that the people may know which is most worthy
of their trust and confidence ; and in the contest
between the old school and new we shall give no un-
certain or doubtful voice. But the question as con-
sidered by legislators is a very different one, and is
contained in the broad political problem of minority
representation. In Michigan, as elsewhere, the ad-
vocates of homoeopathy are still in the minority.
But it is a minority so strong in wealth, in intellect,
in education, in reputation and influence, that its
just demands cannot be trifled with. When such a
minority exists, it would be the most stupendous
folly for the majority to pass over their demands
with contempt. It would be a mistake in policy
which American legislators are too shrewd to make,
a political error from which they are warned by the
whole tenor and drift of republican legislation, which
is the more successful the nearer it approaches the
republican ideal of equal rights to all. When, there-
fore, a minority can say with truth, ' ' We have paid
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for one-third of the cost and maintenance of this
institution, and we desire to be represented in its
management," the demand is a just one, and one to
which an acquiescence is already pledged by the
policy of our National and State governments which
recognizes a minority representation as one of the
fundamental elements of republican organization.
Homoeopathy has received the benefit of the prac-
tical application of this policy by the Michigan
Legislature. The question will be brought, ere
long, before the legislators of other States, and it
would be well for us who have the best interests of
homoeopathy at heart, to keep ever in mind for our-
selves and the public, the fact that we are a strong
minority, taxed for the support of sectarian medical
institutions in whose management we have no voice,
and from whose benefits we and our clients are
practically debarred. We cannot afford to ask as a
favor what should be demanded as a right, and until
we make that demand in a practical and political
way, it will never be granted. We • are glad to
know that homoeopathic hospitals and homoeo-
pathic colleges are gaining in strength and efficiency
throughout the country, and such aid and encour-
agement as we can give them will be cheerfully ex-
tended without partiality and without jealousy.
But the policy of the Medical Union, as regards
homoeopathy, contemplates a broader scheme than
this. We seek to place the old and the new school
face to face before the public. As homoeopathists
pay one-third of the taxes in this city, we claim their
right to be represented in the direction and manage-
ment of our public hospitals and charitable institu-
tions, and if we ever have a State University, we
must have homoeopathy represented in its medical
department. In brief, we claim our right to the
benefits of minority representation.
We cannot predict the result of the late action of
the Michigan Legislature. In common with all true
friends of the cause, we have been sorry to hear of
the constant strife and discord that has lately dis-
graced the fair record of homoeopathy in Detroit.
We are ignorant of the details of this quarrel, and
we do not care to be informed on the subject. We
shall be rejoiced if it "does not prevent the harmo-
nious action which is necessary in order to reap the
full benefit of the victory. With the hope that
those who have striven so long and nobly to secure
the just recognition of homoeopathy in the Michigan
University may use their victory wisely, we wait the
issue with anxiety lest so great a prize should be
miserably lost.
The American District Telegraph Co. is a
nuisance to all doctors who dislike to be called out
at night. The time was when a man would think
twice before he sent for his physician in the dead of I
night. The bitter cold night, or a storm of rain or
snow would induce many to go back to bed again,
and wait till morning. Thus the doctor took his
ease. But now, by the aid of this infernal little
machine, the doctor is summoned by telegraph.
The head of the house just touches a knob and
in two minutes a messenger is at the door; he
receives his orders, and the marvelous celerity
with which he goes for the doctor and delivers him to
the patient, like a bundle of live medicine, is sim-
ply outrageous. The doctor is now sent for three
times where he used to be called once, just because
it is no trouble to send.
Che Jfte6icat Union Clinic.
I take pleasure in forwarding two cases which
have occurred in my surgical practice during
the past month, which I consider of great interest,
not so much on account of their pathological
importance as on that of their rarity.
Case i. Hemorrhoidal Hernia in a boy seven years
of age. H B., of No. — St. James' Place, Brooklyn,
having suffered, at the age of two years, a severe
and prolonged attack of constipation, developed
soon after in a small tumor, half an inch back of
the verge of the anus, which, producing no marked
inconvenience at first, was completely overlooked.
The tumor increased in size, however, and when the
child reached his seventh year the growth was as
large as a walnut, and produced marked inconve-
nience at this juncture.
March 10, 1873. — I was called in consultation by
Dr. Sumner. Upon examination I diagnosticated
a hemorrhoidal tumor, which by the violence of the
strain during the mentioned attack of constipation,
had ruptured the fibres of the sphincter and pro-
truded through them, carrying with it a fold of the
intestinal mucous membrane, forming an external
tumor, which I feel justified in calling a heinorroidal
hernia.
I determined upon a surgical operation, and prac-
tised it in the following simple manner :
Llaving reduced the hernia as completely as pos-
sible, I passed an armed needle internally through
the fold of mucous membrane that formed the at-
tachment of the tumor, and gave the thread to an
assistant, directing him to pull gently, keeping by
this means the mucous membrane within the anus.
I again drew out the tumor through the rupture,
passed a suture pin through its base, in the direc-
tion of the ruptured fibres, then a curved needle,
armed with a double ligature, at right-angles, under
the pin and through the ruptured fibres, and tied
one on each side under the extremity of the pin,
which I then withdrew, having thus not only strang-
ulated the tumor, but also passed two sutures through
the ruptured fibres of the sphincter.
Subsequently the tumor sloughed and the remain-
ing ulcer healed kindly, leaving the parts looking
naturally and the patient in perfect health.
Case 2. Dislocation of the head of the femur in a
lady over eighty years of age. On the 20th March,
1873, Mrs. W , of No. — Henry Street, Brooklyn,
aged 82, while going down stairs, overlooked the
last step and fell forward and outwardly upon the
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89
left knee. She was unable to rise, and was conse-
quently carried to bed where she remained for eight
days,, without any medical assistance. At the end
of that time I was consulted, and found upon exam-
ination that the head of the left femur had been
driven out of the acetabulum upwards and back-
wards upon the dorsum illii. The patient suffered
no actual pain while at rest, but did suffer violently
upon the slightest motion of the trunk, or of the
limb. The dislocation was readily reduced by means
of extension and manipulation combined, and pain-
less motion immediately followed. This is one of
the very few cases on record of dislocation of the
thigh at such an extreme age.
A. Varona, M. D.
Case i. — Adenoma of the Breast. — Miss C, 40
years old, was sent to me by Dr. T. F. Allen, for sur-
gical treatment. The patient had a large tumor occu-
pying the left breast, and its rapid growth, together
with the pain and debility caused by it, seemed to
render its immediate removal necessary. Various
opinions had been given by physicians as to its
nature and probable termination, and indeed, the
appearance of the tumor was so peculiar, that an
accurate diagnosis from inspection alone would
have been extremely difficult. I cannot give a
better idea of its appearance than hy comparing it
to a large bunch of black Hamburg grapes, covered
with a thin investing membrane. The nipple was
retracted. The whole tumor when lifted from its
bed was pretty dense and solid, although it did not
have the stony hardness of schirrus. The tumor
could be moved freely upon the pectoral muscles,
but the skin was adherent to a considerable portion
of its outer surface. There were no. enlarged
glands. There was considerable pain developed by
handling the tumor. The patient was in feeble
health, of sallow complexion, and despondent, but
she did not seem to have the peculiar cachexia of
cancerous disease. The tumor first made its ap-
pearance about two years before it came under my
notice. Under Dr. Allen's care its growth was for
a time arrested, and its size diminished under the
administration of Phytolacca, but latterly it had in-
creased with such rapidity that its removal was
considered advisable.
Jan. 8th, 1872. — At the Hospital for Women, I
removed the entire mass, extirpating every trace of
the tumor and mammary gland. The operation
presented no peculiar difficulties. The tumor came
away easily, as there were no deep attachments, and
the hemorrhage was so slight that no arteries were
ligated. The after treatment was of the simplest
description. The wound healed kindly, and the
patient has as yet no symptom of any return of the
disease. My diagnosis of the disease was : a fibro-
cystic tumor, and my prognosis was favorable. An
examination of the tumor showed, however, that it
was a case of glandular hypertrophy, a true
adenoma of the breast, exceedingly rare and inter-
esting. Billroth remarks concerning these tumors :
a * * From my own observations, I must consider
true adenoma of the breast as very rare ; I have
only seen it once, it was then in tubular form."
Forster and others, however, describe acinous
adenoma of the mamma ; on account of this rarity
not much can be said about the prognosis of these
tumors, which usually remain small. They are
generally considered as entirely benignant ; but, on
anatomical grounds, it seems to me probable that
they cannot differ much in prognosis from car-
cinoma. (Surg. Pathology, p. 614.)
Case 2. — Building up a Nose. — This was a case
where the cartilages of the nose had been eaten away
by syphilitic ulceration, which had also destroyed the
coiumna, separated the alse from each other in the
median line, and left, instead of a nose, a hole
bounded above by the inferior border of the nasal
bones, on each side by the retracted aloe, and below
by the upper lip. This horrible deformity was
remedied, in part, by Dr. Carnochan, who united
the alse, and thus bridged over this nasal chasm,
par glissement. He then formed a coiumna by
turning up an oblong flap from the upper lip, made
through its entire thickness, and left attached to the
lip at its upper end, while the free border was
stitched into the tip of the nose, the divided lip
being brought together by hare-lip pins. This in-
genious operation succeeded perfectly in closing up
the unsightly hole in the patient's face, but the
subsequent retraction of the parts left her with not
much of a nose to speak of. When she came un-
der my care, a line drawn from the bridge of the
nose to the chin barely touched the tip of the nose.
My operation was for the purpose of pushing out
the tip of the nose so as to make it more prom-
inent, and was conducted as follows : An incision
was made, beginning in the right nostril, about a
line from the coiumna, and terminating at the free
border of the lip, in the median line. A similar in-
cision was made from the left nostril, meeting the
first incision at the free border of the lip. These
incisions were carried down to the bone at the upper
part, and included the entire thickness of the lip.
I thus formed a V- shaped flap, the apex being at
the free border of the lip, the base being formed by
the root of the coiumna... The whole flap was in
fact a prolongation of the coiumna through the
upper lip. I now freed the flap from its attachment
to the bone, and at the same time I passed my
knife behind the alae on each side, dividing the
tissues' subcutaneously so as to allow of greater
mobility in the parts. I next united the wound in
the lip with hare-lip pins, beginning at the free
border of the lip. When I reached the upper por-
tion of the lip, I inserted the tip of the flap into the
incision, and included it in the united wound.
Finally, I drew the whole fleshy part of the nose
well forward, and supported it in position by a long
gold acupressure needle, which I passed through the
nose from one side to the other, so as to rest upon
the nasal border of the superior maxillary bone on
each side. The cavity of the nose was then care-
fully filled with pledgets of oiled lint, and the wound
in the lip supported by strips -of isinglass plaster.
The operation succeeded beyond my expectations,
and the result shows that half an inch on one's
nose makes a considerable difference. The only
fault I can find with the result is, that the tip is
elevated a little too much, is rather too much of a
nez retrousse', but as the patient is perfectly satisfied,
I am content to let it alone. This operation was
also performed at the Hospital for Women, May
18th, 1872.
Case 3. — Giant-celled Sarcoma of the Lower Jaw.
—This case illustrates the wonderful rapidity with
which some innocent tumors are reproduced when
the operation for their removal is not sufficiently
thorough. In November, 1870, a girl, 16 years old,
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was admitted to my surgical clinic with a tumor in
her mouth that had been growing about a year.
The growth occupied the place of the second molar
tooth on the right side, was about the size of a pigeon's
egg, and so overlapped the gum as to give the impres-
sion, on superficial examination, that it was merely a
surface growth which could be entirely removed by
a ligature. So convinced was my assistant that the
tumor could be effectually disposed of by the ligature,
that I applied the ligature so as to remove at once all
the projecting part of the tumor, which was of such
consistency that it was readily shaved off by the liga-
ture as by a knife. At the same time I told the class
that they would have an opportunity of seeing for
themselves how rapidly the tumor would form again.
In just one week from that time the patient presented
herself and her tumor again in the clinic, and the
most critical examination could not detect any evi-
dence that the growth had ever been removed or
interfered with — in fact, the tumor had been entirely
reproduced in four days. This time I removed, be-
sides the growth itself, that part of the jaw from
which the tumor took its origin. The wound
healed nicely and there has been, no return of the
disease.
The location of sarcomatous tumors upon the
gums (epulis) is generally only apparent. They
commonly take their origin from the cavities or
sockets of decayed teeth, as in this instance where
the growth sprang from the very bottom of the
tooth-socket. The term " giant-celled " was first
applied by Virchow to a peculiar form of sarcoma,
containing the largest cells of unformed protoplasm
that are ever seen in man. The microscopic exam-
ination of this specimen showed all the characteristic
appearances of the giant-celled sarcoma.
Case 4. — Encephaloid and Schirrus Cancer of
the Eye. — This case is interesting from the probable
occurrence of two forms of cancer in the same organ.
Mrs. Harris, 43 years old, married, came under my
care with a tumor protruding from the right orbit,
and apparently filling the whole cavity. The tumor
was irregular in shape, lobulated, having the ap-
pearance of a fungous growth, giving considerable
pain, and the fetor was a nuisance to patient and
family. It was impossible to obtain from her any
intelligent history of the case, but the main particu-
lars, as ascertained, were these : Fifteen months ago
a small tumor appeared in the inner angle of the
right eye, exterior to the eye-ball. The tumor was
" white, streaked with red." At first it grew slowly,
advancing over the front of the eye towards the cor-
nea. Last March the tumor began to grow rapidly,
extending from the inner to the outer angle, ob-
scuring the whole orbit giving intense pain, and
frequently bleeding copiously, and the color of the
tumor deepened to a purplish blue. The bleeding
has now ceased and the pain has diminished, but
the tumor is increasing in size, and is covered with
purulent matter, which is quite offensive. By push-
ing aside the outer border of the tumor the patient
says she can distinguish light from darkness, though
nothing like an eye can be seen in the cavity, its
place being supplied by a granular purulent mass,
apparently of the same structure as the rest of the
tumor. I find on trial that the sense of vision is
entirely lost.
July 21st, \%66. — I placed the patient under chloro-
form and removed the entire mass contained in the
orbit. There was but little hemorrhage during the
operation ; the cavity was lightly dressed with carded
oakum, and in a few days the patient returned to
her home in another part of the State. An exami-
nation showed that the tumor had obliterated all
traces of the eye, the cavity of the orbit having
been completely filled with the mass. On subject-
ing the specimen to a microscopic examination, I
found a portion of the tumor, from the point of
origin at the inner angle of the eye, presented a
dense fibrous structure, and the interfibrous tissue
was crowded with the cells of hard cancer. This
portion was about the size of a small filbert, and
terminated abruptly in a softer tissue that was easily
broken down under the pressure of the fingers. In
the softer or encephaloid portion of the tumor,
the cells were of large size, ovoid or spherical in
shape, some of them caudate. In many instances
the cells of smaller size were grouped together and
enclosed in one large investing membrane. The
larger cells had sometimes two or three nuclei. No
appearance of fibrous tissue was observed in this
portion of the specimen.
A very interesting pathological question arises as
to the nature of the tumor. The patient was forty-
three years old, past the usual age at which the
encephaloid disease attacks the eye ; indeed, it is
denied by some that encephaloid ever occurs in
adults, and yet there appears to be very little doubt
that the larger mass of the tumor was encephaloid
cancer in that stage of the disease known as fungus
hsematodes. The occurrence of schirrus as part
of the same tumor, as seen in the examination of the
first specimen, is another point of interest. Lastly,
the growth of the cancerous mass seemed to com-
mence exterior to the eye-ball in the ocular con-
junctiva. This might not be inconsistent with the
habits of hard cancer, but is certainly unusual
in the encephaloid variety. - My solution of the
problem, if, indeed, it is a solution, is that the two
forms of cancer attacked the eye separately, the
schirrus coming first and growing slowly from the
exterior; the encephaloid appearing later, in the
interior of the eye, growing rapidly, absorbing all
the structures of the eye, and finally enveloping and
becoming adherent to the schirrus.
John C. Minor, M. D.
Suspended Animation treated with Dry Heat. —
Some time since, on entering a house to which I
had been summoned in a case of labor, I found the
child born, and a physician trying to animate it by
artificial respiration and the other means usually re-
sorted to in these cases. On reaching my patient,
he had found the child in the world with the excep-
tion of the head, which was retained in the vagina.
The mother remarked it had been in that position for
nearly ten minutes. This, probably, was an exag-
geration ; but my friend said when he arrived, the
cord was cold and entirely pulseless. I was con-
vinced that any further efforts of the kind which
had already been used would be useless, and deter-
mined to try the effect of dry heat. Closing all the
registers on the floor, but the one in the room, I
placed some pillows in front of that, and wrapping
the child in a flannel blanket placed it with its back
to the register, but a few inches in front of it. In
a few moments I noticed, for the first time, a faint
gasping, and in fifteen minutes from the time it was
placed in position, was gratified with a lusty cry.
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91
Animation was fully established, and the child is
now living. I have frequently had occasion in these
cases to use dry heat, and in more than one instance
have succeeded in restoring animation where every
other means had failed.
Egbert Guernsey, M. D.
Mammary Abscess. — About three months since, I
attended a lady in confinement; her progress to
health was natural and rapid, and I ceased attend-
ance. A short time after I was called to see her,
and found her with an inflamed breast — one side
swelled, indurated, and painful. I applied Ham.
and Bell., externally, giving Aeon, and Bell., in-
ternally. The next day there was not only no im-
provement, but the inflammation had extended
around to the opposite side. I continued the treat-
ment. On the third day I found no progress for
the better, but rather indications that there would
certainly be suppuration on both sides of the breast
if the inflammation was not checked. From the
intense, shining redness of the gland, I determined
to try Apis. I put about two drachms of the first
dilution in a teacupful of hot water, and applied
cloths constantly wet with it to the breasts, and
gave Apis — second dilution — internally. The next
day, on calling, I'was surprised to see the change.
The intense redness had disappeared, leaving a
pale, pinkish, shrivelled appearance of the skin ; the
swelling was softening and subsiding on the side of
the breast where it made its last appearance. I
continued the treatment. The part first attacked
went on to suppuration, but that was soon over and
healed. From the action of the Apis on the inflam-
mation in this case, I believe if it had been applied
at the first appearance of swelling or inflammation
it would have checked it and prevented a mamma-
ry abscess.
W. Freeman, M. D.
Correspondence,
Buffalo, March 20th.
Editors Medical Union i
Sirs — While reading an article on Sanitary Leg-
islation in the last No. of the Union, I read: "It
should supervise the enforcement of compulsory
vaccination throughout the State."
Would it not be well to specify what the people
are to be vaccinated with ? A physician in the
vicinity of Buffalo (I can give you names if you
wish) was authorized to go through a township and
vaccinate every one of its inhabitants, which he did
— going through several schools. The sequel shows
that not an individual is protected from small-pox,
as several have since died of it, but every one is
diseased, and some for life. Many of the victims
present a sadder spectacle than any case of small-
pox, inasmuch as death would come to the relief of
the latter, while the former only live to suffer.
Ought not the Medical Union try and stop this
wholesale poisoning, which has been going on for
generations, and advocate using no more humanized
virus, but that only direct from the kine.
Yours, in the cause of Medical Reform,
Mrs. E. G. Cook.
342 Washington Street.
Reuieuie of Boohs.
A Manual of Homoeopathic Veterinary
Practice : Designed for Horses, all
Kinds of Domestic Animals and Fowls.
Boericke & Tafel, New York, 145 Grand
Street.
The design of the present work, as stated in the
preface, is two-fold : "The first part relates to the
choice, feeding, training, and breeding of the ani-
mals and fowls useful to man ; while the second
part describes the various forms of disease and dif-
ferent casualties to which these animals are liable,
designates the principal remedies and their chief
indications, and suggests the proper dietetic and
accessory treatment. But to these two general
divisions is added a third, the Materia Medica,
apparently secondary to the latter, but in reality no
less important." The author claims to have em-
bodied in this work the researches and experience
of the best writers and practitioners upon these sub-
jects in the world ; and while the homoeopathic liter-
ature in England, France, Germany, and our own
country, which has recently been so full of practical
suggestions and scientific investigations upon those
matters, has been freely placed under contribution,
the most practical thoughts of the best allopathic
writers have been incorporated in its pages.
The work is of great value, and contains the latest
and fullest information upon the subjects of which it
treats. It will not only form an important addition
to the physician's library, but is full of just that
practical information about the selection, care, and
treatment of animals which every one needs.
Morbus Brighti. By Joseph Buchner, Doctor
of Philosophy and Medicine, Member of many
learned Societies and Academies in Ettrope and
America, President of the Hoinceopathic Hospital
in Munich, Professor at the Ludovico Maximi-
lianea. Translated by Samuel Lilienthal,
M. D. Boericke & Tafel, New York. 1872.
We have greeted with pleasure the appearance of
this work.
Although the increase of our knowledge of diseases
of the kidney has been so great and rapid during
the past quarter of a century, yet there still remains
much that is veiled in uncertainty and obscurity.
Monographs written by men profound in study
and tireless in their researches are always the most
valuable of books. As they are generally the
fruits of the careful observation and long experience
of specialists, they are always regarded as weighty,
and authoritative upon the subjects which they
touch.
We heartily endorse the tendency to monograph
writing, as we think greater advances are made in
science and medicine by the careful and exhaustive
study of single subjects, than in the lightly skim-
ming over of general medical topics.
This book is written by a Homoeopath, well known
in both the old world and the new.
Unfortunately, the translator has failed to put
into flowing language, or express in a lucid manner,
the thoughts of the writer.
Many of the sentences are exceedingly long,
obscure, and ungrammatically constructed; and as
the punctuation is faulty, it is somewhat heavy
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reading. The author, however, conveys so much
that is novel in the aetiology, and is so exhaustive
in his remarks upon the progress and treatment of
Morbus Brighti, that it is well worthy the perusal
of every practitioner, even if the matter is not pre-
sented in a very attractive style.
The writer commences with the history of the
disease. Beginning with the writings of Hippocrates,
he hastily speaks of what has been contributed to
the literature of the subject from then to the present
time. He rather curiously heads the chapter on the
physiology of the kidney, the dignity of the renal
functions. It is complete and exhaustive, and in it he
also shows the functions of the kidney in excreting
medicinal matters, and what changes many remedies
produce in the structure of the kidney. His remarks
upon the kinds of food which affect them, are good,
and important to the practitioner in the selection of
a proper diet for his patients.
His experience of the frequency of the disease
does not concur with that of Frerichs, Traube,
Roberts, and other writers. He says " that among
chronic cases more die from Bright's disease than
from tuberculosis, without counting the acute forms
of uraemia, which, falsely diagnosed and wrongly
treated, are so frequently fatal." Now, from one-
seventh to one- fifth of all people die from tuberculo-
sis, and fully one-fourth at the period of life when
Bright's disease most commonly occurs, which,
according to Dr. Buchner, is from the twentieth to
the fortieth year. Certainly in this country, neither
in hospital nor in private practice, do more than
one-fourth of the fatal cases which occur at this
period of life arise from Bright's disease.
Hereditary influence is strong in this disease, a
point which has hitherto not been much noticed.
He finds it not only transmitted from father to son,
and from mother to daughter, but also more gener-
ally than in tuberculosis from mother to son, and
from father to daughter.
Next in order he speaks of the pathology, which
is very minutely given, but not sufficiently carefully
arranged as to present a clear and striking picture of
the ravages of the disease in its different stages.
He divides it into three stages, that of hyperaemia
and cylinder formation, of fatty infiltration and de-
generation, and of atrophy and cirrhosis.
He does not acknowledge the acute croupous or
desquamative nephritis to be a variety.
In fact, this form occurs usually only in scarlet
fever, measles, typhus fever and cholera; and
it is rare for it to pass into the parenchymatous
form. To prove that the exudation, is not
fibiinous, but rather albuminous, and there-
fore not a result of -a croupous inflammation, he
says: " 1st. It does not act paralysingly on the
affected parts, nor are the neighboring organs
affected excontiguitate ; 2nd, it is not organiz-
able ; 3d, in cholera there is no croupous inflamma-
tion of the intestine ; and 4th, similar processes of
other organs, as chronic catarrhal pneumonia, are by
nobody considered as croup." He passes next to the
aetiology of the disease. In enumerating the causes
he speaks of two novel ones hitherto unmentioned,
viz. : hypertrophy of the thymus gland and diseases
of the cardiac nerves. He thus describes the patho-
logical process of the former : " The tongue-shaped
thymus, when resting on a gonorrhceal, scrofulous
or rachitic diathesis, grows in consequence of pas-
sive hyperaemia, either before or after birth, to the
parietal part of the pericardium, whereby the left
heart is so disturbed in its action, that the muscle
gains in flesh in order to perform its function.
Dislocation is thus more or less produced. When-
ever the pericardium attaches itself also to the
serous membrane of the diaphragm, greater dislo-
cation of the heart, and of the large blood-vessels,
takes place, causing slow albuminous degeneration
of the kidney, but more yet pulmonary stasis and
capillary inflammation, because the passive stasis
divides itself between lungs and kidneys ; but in the
first case, where the left heart alone becomes hyper-
trophied without an affection of the diaphragm, the
kidneys degenerate more quickly." He then dis-
misses it with some remarks upon the prognosis,
from which we learn that it generally occurs during
infancy, and usually runs a rapid course to a fatal
termination,
Of the latter cause he writes : "As all organic
alterations, especially of the right heart, may cause
Morbus Brighti and its pregnant partial phenomena,
and as we have shown that it may, on the part of
the venous circulation, emanate from the kidneys,
so we may also declare, that all imitations of heart
diseases, i. e. , affections of the nerves of the heart,
especially hyperaesthesia, neuralgia and neuralgia
intermittens, neuroses of motility in general, may
be followed, after lasting some time, by uraemia up
to albuminuria, may reach in intensity the forms of
the former, but they seem to run their course in a
shorter time, and are less dangerous."
These fine-spun theories should not be called
" far-fetched " or absurd, but rather be passed by
in silence until they be proven or disproven by fur-
ther investigation, and other methods of reasoning.
They at least show our author to be an original
thinker as well as a close observer. They indicate
the patient, plodding, searching, German mind, to
which the art of medicine owes so much for her re-
cent advancement, and the scientific world is so
deeply indebted for very many of the recent dis-
coveries in science and the collateral arts.
In speaking of the relation of Bright's disease to
hypertrophy of the heart, he does not coincide with
the common opinion of modern writers, that the
la,tter is a sequela of the former. He does not
arrive at his conclusions, however, simply from the
experience in his practice, but deduces from the
results of his experiments with drugs upon animals
that as in the artificially produced Morbus Brighti,
the heart is primarily affected, the same conditions
must necessarily prevail in the true disease. Then
follow the chapters on the prognosis and differential
diagnosis, which are nicely arranged and well
written.
In speaking of the symptoms he lays much stress
upon the nervous derangements arising from the
presence of carbonate of Ammonia in the blood.
He does not entertain for a moment the idea that
they may arise from the retained urea, far se, but
speaks of the certainty of carbonate of Ammonia as
the toxic irritant with an assuring positiveness
which utterly disarms one of the idea that he is
touching upon a disputed point which is not as yet
satisfactorily settled. His description of the origin of
the carbonate Ammoniate from the splitting up of
the retained urea under the fermenting fibrine is
exceedingly good. At last he enters upon the
therapeutics ; in the chapter on diet we learn that
here everything is to be avoided which acts medicin-
The Medical Union.
93
ally upon the kidneys ; such as champagne, Mo-
selle, parsley, onions, asparagus, etc.
The two great remedies, he says, are Arsenicum
and Phosphorus ; Cuprum, Aurum, Terebinth, and a
few others are useful in meeting certain symptoms.
" Arsenicum and Phosphorus bear a proportion to
each other as right to left ; Arsenicum affecting
the left heart, Phosphorus the right one. In other
words, the former causes arterial stagnation, the lat-
ter venous stagnation with or without disturbance
of the lesser circulation."
Consequently he uses Phosphorus when the
right heart or pulmonary artery are implicated, or
when the disease is complicated by lung difficulties;
Arsenicum in the simple uncomplicated form, or
when hypertrophy of the heart is co-existent. The
results of his provings of the drugs are elaborately
given, and contain much of interest. Many of the
conclusions deduced upon the action of drugs on
the human system are full of theory, which is as
novel and entertaining as it is fanciful. To the
phenomena produced he draws particular attention,
because he says in eclampsia the question arises
shall Arsenicum or Phosphorus be given ; to which
he answers: " The solution is simple ; Phosphorus is
indicated in symptoms of cerebral atrophy, and
Arsenicum in oedema cerebri." The last concerning
Arsenicum is correct, for it is generally acknowl-
edged at the present time that oedema of the brain
is a frequent cause of convulsions and coma. As
oedema of the body is usually more or less extensive,
and as we know from the ophthalmoscopic revelations
that it very often extends to the brain, certainly
where these conditions prevail Arsenicum is a good
remedy.
But cerebral atrophy has not hitherto been recog-
nized in Bright's disease, and as our author gives
neither experiments nor proofs to sustain his asser-
tion, his theory should be received with caution.
Atrophy of the brain has so far been only recognized
in brain diseases, as a result of old age, and at the
close of long exhaustive diseases. In all of these
conditions Phosphorus is the great remedy, but it is
doubtful, even if our author's premises are correct,
that cerebral atrophy could be diagnosed amidst
the train of nervous phenomena which follow
Bright's disease. Then follows a well- written chap-
ter on uraemia — he defines it as a "toxaemia by car-
bonate of Ammonia, which under certain conditions
abnormally arises within the circulation, whenever
the urea putrefies before its passage through the
longitudinally stretched vessels of the renal pyra-
mids ; i. e. , whenever it can draw one per cent, of
water within the reach of its formula." Further on,
in the remarks upon the origin of the carbonate of
Ammonia, he says : " Mobile azotic protein bodies,
which in a state of molecular motion set up fer-
menting processes in stationary indifferent carbona-
ceous hydrates, and in other matter with which they
come in contact, act, according to Kletzinsky, as fer-
ments, as instigators to putrefaction, as metabolic
matter. The excrementitial urea begins to putrefy,
when, stagnated by disturbed excretion, it meets
the catalytic power of an anomalous, loose, dissolv-
ing fibrine. Only accumulated urea is present in
the blood ; a softer retrogressively decaying fibrine
meets it, and becomes itself a ferment, and through
propagation of its decay hands it over to hydratation,
a negation to oxydization and life." He enum-
erates the causes of uraemia fully and clearly, men-
tioning among them, the nutritive disturbance of a
portion of the fossa rbomboidea of the brain. He
divides uraemia into four forms: "The comatose,
occurring in scarlatina, measles, intermittent fever,
genuine Morbus Brighti ; the eclamptic, in preg-
nancy, puerperium, hypertrophy of the thymus,
whooping-cough ; the asphyctic, in Asiatic cholera,
myocarditis ; the paralytic, in some epidemics of
cholera, and in lying-in women."
This division is good and serviceable, and he
describes each form quite fully.
The remedies which he has found most valuable
are Arsen., Cupr., Phosph., Aurum, Terebinth,
Prussic Acid, and Nicotine. In the remainder of
jthe book he devotes a chapter each to the waxy
kidney, albuminuria, and dropsy. He heads the
first of these, Morbus Brighti Syphiliticus, which
seems quite an. appropriate title.
The translator adds an appendix, containing brief
remarks upon the "newest" remedies which have
been used in this disease, with some valuable com-
ments.
In conclusion, notwithstanding the intricately
entangled sentences, the many obscure passages,
we have read this book with a great deal of interest.
It contains much that is valuable. Good books,
like fine paintings, often become more enjoyable upon
close scrutiny and repeated examinations. So this
bears well re-reading, as it contains so much of
practical value, locked up in finely-woven theories.
W. N. G.
{Transactions of Societies.
MEDICAL SCIENCE ASSOCIATION.
A MONTHLY meeting of the Medical Science Asso-
ciation was held March nth.
Dr. Minor made some remarks upon Tracheotomy.
He exhibited a new instrument to be used instead
of the ordinary tracheotomy tube. The objections
to the ordinary tube are many, and are too well
known to need any recapitulation. Among the
most important are, ist, the difficulty of keeping the
tube clear from mucus, shreds of membrane, etc. ;
2d, the necessity of having several tubes of different
sizes in order to accommodate the instrument to in-
fants or adults. These and other objections are
overcome in Dr. Minor's instrument, which consists
of a pair of wire retractors, curved somewhat like
an ordinary tracheotomy tube. These retractors
slide upon a wire bridge, on which they can be
fastened at any point by the turn of a screw. When
closed, for insertion into the trachea, they present
a thin, rounded surface, the thickness of two wires,
thus rendering this part of the operation much more
rapid than when the bulky tracheotomy tube is used.
When the wires are inside the trachea they are
passed down till the bend of the wire, correspond-
ing to the shoulder of the ordinary tube, comes
down to the surface of the skin. The wires are
then separated as widely as the operator prefers, and
fastened in position. The instrument is retained in
its place by a tape around the neck as in the case of
the ordinary tube. When the instrument is in situ
its advantages are seen at a glance. The wound in
the larynx is held open by an instrument which
practically occupies no space in the larynx. The
larynx is unobstructed. There is no tube to become
94
The Medical Union.
blocked up. If suffocation occurs from membrane
or mucus the offending substances can be reached
directly through the wound, and the patient's life is
never perilled by the obstruction of the instrument.
The eye rests upon the mucous membrane of the
trachea which is not hidden at all by the instrument,
and thus the diagnosis and prognosis of the case is
easier than when the trachea is filled with a tube.
The instrument is valuable in operations for the
purpose of removing foreign bodies from the wind-
pipe, cases in which the tracheotomy tube is useless.
In answer to a question from Dr. Ellis, Dr. Minor
gave it as his opinion that tracheotomy was always
preferable to laryngotomy when undertaken for the
relief of croup or diphtheria in children. The
operation is one of variable facility, sometimes
being wonderfully easy and rapid of execution, and,
in other cases, being exceedingly difficult and
dangerous. In the adult it is generally performed
readily enough, but in infancy, when the neck is
short and fat, the operation is generally difficult
and tedious.
A discussion followed upon the medical treatment
of membranous and diphtheritic croup.
Dr. Hallock recommended the use of the vapor
of iodine. He did not restrict it to local use, but
allowed the whole room to become 'impregnated
with it. A few grains of iodine are put into a shal-
low vessel, which floated upon a larger one, con-
taining water in a state of constant ebullition. The
generated steam disperses the iodine vapor through-
out the room. The vessel should be a large one
that the steam may be furnished in large quantities.
Dr. W. N. Guernsey commended the use of
Bromine.
It is nebulized into spray by means of a steam
apparatus, and used for ten minutes at a time at in-
tervals during the day and night. He uses it ac-
cording to the folio wing formula :
Recipe — Bromine, i grain ; Potassii Bromidi, I
drachm ; Aquas, I ounce. Mix.
It stimulates the mucous membranes powerfully,
and often, under its use, the membranes are thrown
off. Owing to its irritating properties, the eyes
should be properly protected.
Scientific iBleanings*
Diagnosis of Death by the Pupil. — If a
fully dilated pupil is found in connection with the
cessation of the respiration and the circulation, we
may safely conclude that life is extinct, and that the
process of artificial respiration would be futile.
In a case of bronchitis in' a child, death had ap-
parently suddenly taken place, but the pupil re-
mained contracted, and artificial respiration brought
the little patient round, with the aid of friction to the
feet and legs.
Sponge Tents.— To Prepare Rapidly. — Having
wet the sponge to be used with water, and then
pressed it as dry as the strength of the hand will
allow, press it into a quill, or any suitable tube
or mould. If it is now immersed in spirit suf-
ficiently strong (90 to 100 per cent.), it will im-
mediately set into the given shape, and will be hard
and inflexible, and can be cut or trimmed to a point
if desired. To restore it to its former size and
shape it is only necessary to moisten it with a few
drops of water.
Spina-Bifida. — Ligature. — A case of spina-bi-
fida is related in which the tumor was successfully
removed by means of ligatures. Two days after
birth a silk ligature was applied round the neck of
the tumor and only tightened slightly. The follow-
ing day another ligature was applied a little tighter
without disturbing the first, and the following day a
third. The three ligatures were all kept on until
the tumor sloughed off, which it did in three weeks,
leaving only a very small wound, which readily
healed. Three years have now elapsed and the
child is strong and healthy.
Varicose Veins. — Obliteration. — The division
of veins on account of varicosity, if unaccompanied
with some measure whereby the divided ends are
effectually occluded, is a proceeding attended with
great danger. Two needles should be passed under
the vein ,to be divided, and slight pressure ma4e
on the vessel by means of ligatures passed over the
ends of the needles. The vein may be now divided
subcutaneously between the needles with perfect
safety. By about the fourth day all symptoms of
irritation will have subsided and the needles may be
removed. This simple plan of treatment is very
effective in the cure of varicocele.
Transfusion of Blood. — In the year 1667, the
Royal Society witnessed the successful transfusion
of the blood of a sheep into the circulation of a
man in perfect health. The subject of the experi-
ment was Arthur Coga, who, as Pepys says, was^ a
kind of minister, and, being in want of money,
hired himself for a guinea. Drs. Lower and King
operated, injecting twelve ounces of sheep's blood
without producing any ill effect. The operation
was repeated, in a day or two afterwards, on Coga,
when fourteen ounces of sheep's blood was sub-
stituted for eight ounces of his own. Pepys went
to see him, and heard him give an account in Latin
of the operation and its effects.
Chronic Bright's Disease. — Change of Cli-
mate.— It is found that the mortality from renal dis-
ease is infinitely greater in England than in warmer
and less changeable climates. In St. Mary's Hos-
pital, London, the proportion of deaths from renal
disease to the total number of deaths is as 1 to 31,
in the whole of London as 1 to 49, in Paris as 1 to
266, in Bombay as 1 to 2,800, in Genoa as 1 to
4,303. These facts warrant the expectation, in
cases of chronic Bright's diseases occurring in tem-
perate climates, that arrest of the diseases or re-
tardation of their progress, as well as increased and
prolonged tolerance of them, may often be effected
by a timely change of climate.
Torsion of Arteries. — Mr. T. Bryant has
made many interesting experiments upon torsion of
arteries. After the ends had been twisted, the
arteries were filled with vermilion-colored wax in-
jection, and sections subsequently made. In the
majority of cases it was found that the hemorrhage
is arrested simply by the inner coat being divided,
and curving inwards, forming complete valves, not
unlike the semilunar valves of the heart. This
is the most perfect mode of closure, and to procure
it the artery must not be too much twisted, and
twisting of the end completely off is to be avoided.
Four or five turns are generally quite sufficient for
the purpose wanted. In some cases the inner coat
does not incurve, but breaks up more or less into
shreds, the blood coagulates amongst these, and the
The Medical Union.
95
artery becomes firmly closed, but the support of the
external coat is necessary. The more the end of a
large artery is twisted, the more is the inner coat
broken up, and the greater is the danger of dis-
turbing its valvular incurvation.
Nursing Sore Mouth. — Dr. N. S. Davis re-
gards the affection as arising essentially from a
deficiency of phosphatic salts in the blood. The wo-
man, in furnishing from the blood the material
necessary for the nutrition and growth of herself
and child, does not assimilate these salts just enough
to supply the demand. The indications for treat-
ment are chiefly to supply this deficiency, and no
tonics merely as such, which do not contain these
salts as prominent constituents, will do any perman-
ent good. As soon as the patient feels the scalding
and tender sensation about the edge of the tongue
and mouth, she should be required to take regu-
larly a fluid drachm of the compound syrup of the
hypophosphites at each meal time. Another ex-
cellent prescription is the mixture of extract of
malt, two parts, and compound syrup of hypophos-
phites one part, given in doses of a small table-
spoonful at each meal.
Experiments on the Circulation of Frogs.
— Dr. Boldt has been studying the effects produced
by the active principle of drugs thrown into the cir-
culation of frogs. -The intestine and mesentery were
exposed, and the movement of the blood watched
through the microscope. Twelve experiments of
digitalis showed that it produced a strong contrac-
tion of the peripheral vessels, which is followed by a
marked slowing of the pulse, and this, if the dose be
large enough, by laming of the heart, as shown by
smallness, rapidity and irregularity of the pulse,with
a vibrating or undulating blood-stream ; finally,
after a short increase in rapidity, the pulse falls with
great suddenness, and then, with general vasa motor
paralysis, the animal dies. Eleven experiments
with veratrine show that it directly paralyzes the
heart and arterial muscles. Twelve experiments
with ergotine resulted in a constant lowering of the
pulse rapidity, by both large and small doses, accom-
panied by peustaltic or wave-like contractions and
expansions of the artery.
Quinine in Whooping-cough. —Dr. Letzer-
ich, of Germany, asserts that he has discovered a
form of fungoid growth which vegetates in the
epithelium of the air-passages, and by its irritation
causes the convulsive attacks of coughing. The
expectorative mucus, he says, in patients suffering
from pertussis, contains masses of brownish-red
spores with occasional threads of mycelium, which,
in the latter stages of the disease, become very
abundant. These observations were made by ex-
periments on rabbits, into whose trachea he intro-
duced the fungus. In a short time the latter
became affected with a noisy and violent cough —
a genuine whooping-cough. On being killed, the
air-passages of the rabbits were found to contain
the same fungus as that found in the sputa of
human subjects ; the mucus presented precisely the
same appearance. It is well known that Quinine
has a powerful, destructive effect on true fungi and
fungus germs, and for this reason Dr. Letzerich,
Prof. Binz, and other eminent pathologists, have
used" it in cases of whooping-cough, with, as they
say, the most satisfactory results. They give it dis-
solved by acid in pure water, in doses of from
half a grain to a grain every one or two hours.
Causes of Horse Influenza. — This subject
is very ably discussed by Prof. Law in a recent
number of the Lens. That it was not occasioned by
elevation or soil he concludes from the fact that the
epizootic raged with equal severity among the
mountains of Vermont and New Hampshire and on
the flat malarious sea-coast of New Jersey, Mary-
land and Virginia. That it could not arise from a
low temperature, as some believed, was shown from
the fact that it had a three-fold greater fatality in
Fuller Co., Georgia, than in Dodge Co., Wiscon-
sin. The meteorological tables of Toronto, where
the disease first appeared, show that it could not
have been occasioned by sudden changes of tem-
perature; in September, the month of the outbreak,
there was the average barometer and thermometer,
and the relative humidity of the atmosphere was
normal. There were no acrid or fetid fogs in Sep-
tember, but that month was marked by a high de-
gree of electric disturbance in the atmosphere in
Toronto, and this, though not the cause, very likely
predisposed the system to an attack of poison which
previously existed. The real cause, Prof. Law thinks,
is contagion. The contagion in this case is specific,
confined to one species. Breaking out first in
Toronto, it radiated in all directions, following the
great routes of travel; and its progress is in nearly
every instance traceable to the importation of ani-
mals from infected districts. Of the nature of this
contagion, there are two theories. One is that the
poison consists of fungi, or the like; the other sees
in the granules existing abundantly in the diseased
organs, the morbific agent. These multiply rapidly,
and are conveyed to a considerable distance through
the atmosphere in the clothing of human beings.
Prof. Morehouse found in the matter from a
diseased horse's nostril, and also in the air, the
spores of these cryptogamous plants, but he does not
tell us whether these same spores were in the air
long before or after the disorder, as well as during
its prevalence. We have the authority of Dr.
W^oodward that no specific vegetable germs have
been found in the air, blood or nasal discharges
during the prevalence of the influenza.
Isfews 3iem$*
The Emperor of Austria is making a col-
lection of skulls of remarkable criminals.
Seventy-four Medical Periodicals are pub-
lished in the United States, and more are coming !
[The following paragraph is going the rounds of
all the papers without denial from the parties in-
terested, and we fear that it is true : ]
Prof. Koch, of the Flahnemann College, who
disappeared from Philadelphia three weeks since,
has been discovered to be a defaulter, having
squandered the funds of the college by his dissipated
habits.
City Homoeopathic Hospital, Albany. — This
new Hospital is now open for the reception of pa-
tients, and all medical and surgical cases among the
poor are treated gratuitously. During the past
month the income from the private wards has been
sufficient to meet the expenses of the hospital.
The Hon. Erastus Corning is President of the Board
of Trustees and H. M. Paine, M. D., is the Medical
Director.
96
The Medical Union.
The University of Berlin has 1,918 matric-
ulated students for the winter session 1872-3. Of
this number 404 belong to the medical classes, 13
being Americans.
The Boston University. -Some time ago the Hon.
Isaac Rich, of Boston, bequeathed a fortune of sev-
eral millions of dollars for the purpose of establishing
a University in the city of Boston. The plan involved
Colleges of Theology, Medicine, Law, and Univer-
sal Science. At a recent meeting of the trustees of
the University it was unanimously resolved to place
the Medical Department under the control of the
homoeopathic physicians, and thus another grand
step in the right direction has been taken. To be
sure, the honor will cost the friends of homoeopathy
something, as it is necessary for them to raise some
two hundred thousand dollars, but the same spirit
that made of the Fair such a success will not be
wanting to fulfill this obligation.
Circular of the Bureau of Anatomy, Phy-
siology and Hygiene. — In compliance with the
resolution adopted at the last meeting of the Ameri-
can Institute of Homoeopathy, the Bureau of An-
atomy, Physiology and Hygiene has selected the
following subject for discussion at the next annual
meeting :
What is the best diet for the sick in general, and
what the best in particular diseases ?
By opening the subject of diet on this broad
basis, it is hoped that the discussion may elicit
much practical matter relating to this important
subject. Papers pertaining to this subject, or to
others connected with this Bureau are earnestly so-
licited. Communications should be directed to the
Chairman, or to other members of the Bureau. Dr.
A. R. Thomas, Philadelphia, Pa., Chairman; Dr.
j. D. Buck, Cincinnati, O. ; Dr. S. S. Guy, Brook-
lyn, N. Y. : Dr. R. N. Foster, Chicago, 111.
Brooklyn Nursery. — This very excellent insti-
tution, of which Dr. H. F. Aten is physician-in-
chief, and Dr. J. Freeman Atwood, visiting phy-
sician, has just presented its first annual report. We
cannot give a better idea of the objects of the nur-
sery than in the graphic picture presented by the
report. "Our means being limited, and our quar-
ters contracted, we were obliged to refuse over one
hundred children. Our hearts were made sor-
rowful when we saw those mothers turned away
with their babes in their arms ; sometimes a father
with his motherless ones, or a kind woman who
came bringing a little helpless child without father
or mother. Nearly all these applicants were persons
who desired to be at work, and wished to pay for
the care given the child. Some parents chose to
remain in the institution as nurses to their own and
another babe, and this desire we always encouraged.
We have shunned making this a pauper institution,
feeling that if the mother pays a price, however
small, for her child's board in proportion to the
wages received, it acts as a healthy stimulant to fru-
gality and industry. The number of children who
have been admitted to and cared for at the Nursery
is one hundred and thirty. Of this number twenty-
six have been taken away by death. Several of
these were feeble, one or two of them nearly dying
children when brought to us. Others from birth
had the seeds of disease sown in them, but to each
every care and attention was given by matron and
physician, the nurses joining with them in their
close vigils and patient watching." The fatality, it
will be seen, is very much less than in institutions of
a similar character under allopathic care, while the
amount of real practical work and good accomp-
lished speaks well for the future of the infant nur-
sery.
Mortuary Report in New York. — The deaths
in the past twelve weeks have amounted to 6,294 —
a weekly average of 524— against 6,732, or a weekly
average of 561, in the corresponding season of 1872.
It is gratifying to learn from the foregoing state-
ment that the present year has thus far exhibited a
death-rate considerably less than its predecessor,
although we shall find that certain diseases have
been particularly fatal during the winter, notably
puerperal diseases, erysipelas, diphtheria, croup,
rheumatism and gout. The mortality of those af-
fections, however, more directly subject to sanitary
control, h,as diminished to a very low figure. Chief
among these may be mentioned small-pox, typhus
and typhoid fevers. In the period under considera-
tion, zymotic diseases produced 1,477 deaths; con-
stitutional diseases, 1,511; local diseases, 2,636;
developmental diseases, 445, and violent causes,
225. Puerperal diseases have occasioned 137 deaths
against 125 in the corresponding period of 1872,
when they were likewise unusually fatal. Nearly all
of these cases have been returned as puerperal fever
or puerperal metro-peritonitis. The coincident prev-
alence of such affections with erysipelas was notice-
able also in the winter of the past year. Of the y$
deaths by erysipelas thus far reported this year, 49
have been in children under five years of age, and
mostly young infants. There have occurred 96
deaths by cancer, and 1,036 by phthisis pulmonalis,
against 86 and 1,051 respectively in the same period
of the past year. In the week ending March 8, 106
deaths were due to phthisis, 185 deaths have been as-
cribed to heart disease, and 225 to Bright's disease
and nephritis. Pneumonia, although very preva-
lent, has not caused so many deaths as in the cor-
responding season of 1872. Then they amounted
to 697 against 659 this year. The disease recently
prevailing has, however, been distinguished by a
more asthenic type, and a larger proportion of its
cases have been associated with bronchitis. Thus,
among the latter class there have been 91 deaths,
against 69 in the first twelve weeks of the previous
year, and of cases of typhoid pneumonia, 29, as
against 16. The mortality by pneumonia among
adults has also been proportionally much greater
this year than last. Bronchitis has caused 324
deaths — an excess of 21 over the same season of
1872. There has been a remarkable mortality by
rheumatism and gout — 46 deaths having been due
to the former and 1 1 to the latter, against 27 for
the former and none for the latter in the first twelve
weeks of the past year. Gout, in fact, has hereto-
fore been a very rare cause of death in this city —
but 15 deaths having been ascribed to it during the
five years preceding the present one. Of these, 12
were males and 3 females. Of the 1 1 deaths thus
far reported this year, 1 o were males and 1 female ; ;
187 deaths have been the result of accident or neg-
ligence, 25 of suicide, 12 of homicide, and one of a
judicial execution. Within that period of two years
104 homicides have been committed in this city;
1,190 of the deaths reviewed have occurred in
hospitals and other institutions ; 352 have been per-
sons seventy years old or over, and 2,712 of child-
ren less than five years of age.
The Medical Union.
97
iDriginal Articles.
MINNESOTA CLIMATOLOGY.
By Rev. S. Y. McMasters, D. D., LL. D.
My heading may not indicate just what I wish to
present, but it may serve to suggest it.
Minnesota lies between 43 ° and 49 ° of north
latitude. The northern part of the State is but
little known to the white man. Before the locating
of the North Pacific Railroad on or near the par-
allel of 470, it was scarcely known north of Sauk
Rapids, save to those connected with the military
stations of Fort Ripley, on the Mississippi, and Fort
Abercrombie, on the Red River, and some traders
down the Red River, to Fort Garry, in the British
Possessions.
St. Paul, the capital of the State, is about 45 °
north and nearly 900 feet above the sea level. Not-
withstanding about one-twentieth part of the State
is said to be covered by water (lakes), the atmos-
phere is more dry than that of any State this side
of Nebraska. On a bright March day, thermometer
400 and snow rapidly melting, the humidity is not
above 35 per cent. (100 being saturation), and dew-
point 19. In midsummer, with thermometer at 80,
it is common to see the humidity not above 35, and
dew-point at 54. Of course> I speak of the average
humidity of the day, and not of the night; for we
have dews at night, though often in summer not
until after midnight.
The thermometer gets very low in winter. Once
or twice, within the last ten years, I have seen it at
40 below zero. I speak for St. Paul. At Brainard
it has been far below this several times this winter.
We seldom have any thawing from the commence-
ment of winter until in March ; and this year we
have had the thermometer at 300 in early March.
The time of closing of navigation in the Mississippi
is generally about the 1st of December, and the
opening about the 20th of April.
The average rain-fall per annum at Fort Snell-
ing, six miles above St. Paul, since 18 19, has been
about 26 inches. This is shown by the records of the
post, which was established in 18 19. This includes
snow water.
DISEASES.
The diseases of the State may not be just what
you would judge from these data. Fever and ague
can hardly be said to exist here, save in imported
cases. No case, it is asserted, has ever, originated
above Lake Pepin. I have never seen a case
here. Remittent, Typho-malarial and Typhoid
fevers are common here — worse in the winter than
at any other time ; though they are not uncommon
from August until April. This winter it has been
more prevalent and, I think, more fatal than ever
before. Is this to be referred to the unusual severity
of the winter ? Consumption is here also. About
five hundred deaths occurred in the State in 1871
from this disease. More than half of these were
persons who had come here in the advanced stages,
with softening of the tubercular matter already be-
gun. About two hundred and fifty had come, from
nearly all parts of the world, in less advanced stages ;
and less than fifty were natives of Minnesota. In
the same time not less than one hundred and fifty,
who had come in hope of benefit, found relief, and
either returned home or settled here with the feeling
that the danger was past. I think the opinion pre-
vails here that our climate hastens death in the very
advanced cases. Many sad cases we have had of
persons coming here in incipient consumption —
rapidly improving — returning East and, soon after,
relapsing and dying. Others have, in their relapse,
hastened back here, but found none of the benefit
which they had found before. Hence, I would urge
all persons who find themselves benefited by this
climate to remain in it, and not hasten East or
South because they feel well. " Like causes pro-
duce like effects." Doubtless the accounts which
have gone abroad of the salubrity of Minnesota have
been overdrawn, especially in respect of consump-
tion. That it is better for incipient consumption
than any other part of the United States I firmly
believe ; though, doubtless, there are many cases
in which a milder climate' would be better.
Pneumonias and Pleurisies are not common here,
as compared with the more Southern and Eastern
States. In ten years in this city I have not known
of half a dozen deaths from these maladies ; though,
doubtless, there may have been more.
Some cases of Cerebrospinal Meningitis have
occurred here (generally fatal), but it has never
been an epidemic. Farther north it was an epi-
demic a year ago, but in milder form ; and the per-
centage of deaths was not greater than in Typhoid
Fever — perhaps fifteen.
Rheumatism is a wide-spread disease, but in mild
form and generally involving the neuralgic element.
Very rarely we have a case of Inflammatory Rheu-
matism. I have not known of ten cases in St. Paul
in ten years. The chronic cases are troublesome,
but I have never known a case of helplessness or
permanent decrepitude.
Summer Diseases among children in the teething
period are common ; and many persons complain,
in this city, of this being "a hard climate on chil-
dren." Of course, many children die every sum-
mer; but I am sure that in this respect St. Paul
stands far above any city in which I have ever
resided south and east of this. Compared with
Chicago, St. Louis, Louisville, and Memphis, it is
a " City of Refuge " for children.
And yet I have my doubts whether this country
is going to stand well in respect of longevity. Our
stimulating climate seems to admit of no rest.
Everything is in bustling activity and constant
tension, and I fear otir men will wear themselves
out prematurely. Besides, we have drinking here
as well as elsewhere ; an H it is now pretty well con-
ceded, I think, that this vice is fatal very much in
proportion to the dryness of the climate. Our expe-
rience, thus far, has justified this theory; and, be-
tween drinking and ."overexertion, I fear many of
out most enterprising and useful men are to find an
early grave. Many diseases we have simply in com-
mon with all other parts of the United States.
St. Pahf, Minnesota.
Dr- J- C. Hempel will soon publish a work to be
called the Science of Homoeopathy, or a Critical
and Synthetical Exposition of the Doctrines of the
Homoeopathic School.
98
The Medical Union.
A CASE OF LABOR.
By A. K. Gardner, M. D.
Into the life of every man there are events which
form eras in his existence, periods from whence
other events are dated, memories which are never
effaced, indelible scars upon the mind. Courts have
decreed that dates may be authenticated without
any reference to figures or fixed days of the month
or year, by reference to such great events ; thus the
date of signing a deed may be sufficiently attested
to by the statement that " it was the week my son,
George, was born," or " the day before my dear
Mary died " — leaving to other evidence to fix the
dates of these occurrences.
In the same manner there come to the medical
man events — cases so marked in their character
that they are never forgotten ; nay, more, which
modify the thought and affect all his future career ;
whose minutest detail comes back to the mem-
ory, in the walk through the thronged street, no
less than in the visions of night, " when deep
sleep falleth upon men." It is one of those cases
peculiar in its nature, almost overwhelming in its
responsibilities — one of those cases where the able
man can do, does do so much, exhausting scien-
tific appliance, and yet where the result is so
seemingly worse than nothing — one of those cases
where the weak, timid man renounces his pro-
fession, and, in despair, turns to other pursuits. Such
is the case that I am about to attempt to describe.
I can but portray the bald features and salient out-
lines; all the morale, the surroundings, the in-
effable halo of purity and saintliness which gilds
all, the uncomplaining fortitude, the reliant serenity,
the cheerful compliance with every request of her
physicians, these and many like characteristics and
attendants upon the case I cannot portray — although
part and parcel of that which characterizes this as
one of the most remarkable events in a practice of
thirty years.
Mrs. B was personally known for twenty
years to Dr. Bassett, and he was her medical at-
tendant for very many years. In July, '72, she
married at about the age of 40, and menstrated but
twice afterward. She went on without an un-
pleasant symptom until the first of March, hearty,
robust, and in every respect a pattern of health.
At this time, without any apparent cause, she
suddenly found herself sick, a large quantity of
a watery fluid flowing from the vagina. By Dr. B. 's
advice she remained quiet, upon the. bed and
lounge for ten days, with more or less oozing of
amniotic fluid, till it was supposed all had escaped,
but without pain or any symptom of an untoward
character.
On the eighth of April she, for the last time,
went out for a drive in the Park, and was in fine
spirits and apparent health. On Monday she
noticed herself bloating — limbs, feet and face in a
few hours rapidly increasing. Dr. B. examined the
urine and found large quantities of albumen in it.
These symptoms increased markedly during the
following day, notwithstanding the remedies given
for their relief. On Wednesday morning early she
was taken with labor pains (although but seven
months and three weeks pregnant, as supposed)
and this was accompanied by obscuration of
vision so that she could not ocularly distin-
guish, at three feet distance, Dr. Bassett from
Dr. Paine who had been called in consultation.
There were fears of convulsions, as she was restless,
unable to sit down, and although her intelligence
was perfect, there were unpleasant feelings in her
head, and numbness in limbs. Dr. Gray, who then
saw her, counselled venesection, but which was not
however performed, and as the event showed would
have been unavailing.
About 4 P. M. she had a vaginal haemorrhage to
some considerable extent, and subsequently the
blackness of vision was not noticed.
I saw her at 6 P. M., and Dr. Bassett, giving me
the aforesaid particulars, continued by saying that
there had just been a gush of amniotic fluid, upon
which statement I enquired — thinking of the pre-
vious haemorrhage — " Are you sure it is the waters,
may it not be serum from effused blood, the crassi-
mentum being retained ?" Of this anon.
Upon personal examination I found the patient
a lady of some forty years, weighing about 160, of
joyous, sanguine temperament, just now lying
down for the first time, undismayed by the situation
in which she found herself. Face puffy, of a sallow
hue — but as I was informed much better than pre-
viously— pulse 130, irritable, somewhat full. The
os uteri, which, at 4 P. M. first began to dilate and
with great difficulty admitted Dr. Paine's finger,
was now an inch in diameter, but excessively firm,
the os internum in the height of a pain, cutting the
finger to a painful degree. With her pains she
made no effort at straining and said that she felt as
if paralyzed. There was a constant bloody oozing
of a watery character, and once a gush which I sup-
posed (as had Dr. Bassett previously) by its
character and time, at the height of a pain, and color
as of slightly bloody water, to be amniotic. We
discussed this point, considering it to be some re-
tained fluid, and perhaps thought that the pre-
vious discharges had been " false waters."
We were unanimous in the opinion that every
effort should be made to hurry on the dilatation and
effect delivery as speedily as was possible by any
practicable means. I, to that intent, endeavored to
assist the dilatation of this rigid os uteri.
9.30 P. M. — The os was sufficiently opened to
justify attempts to introduce the forceps within it,
and seizing the presenting occiput to attempt
speedy delivery, there being no alleviation in her
symptoms, the pulse indicating 138 to 140. She
was accordingly placed in position and chloroform
administered with great caution. I, with some dif-
ficulty, but rapidly, passed Ritgen's narrow bladed
forceps and applied the blades safely over the head
of the child. She bore the chloroform remarkably
well, but little being required to bring her under its
influence. The pulse got fuller and more steady
under its administration, but the breathing became
wofully labored and rapid. Her danger was im-
minent. She had required to be fanned during
the entire evening previous, and now, letting-up the
anaesthetic, we gave her teaspoonful doses of Squibbs'
extract of 'Ergot to insure future contraction, and
before any attempts at delivery were undertaken.
The increased frequency of breathing and some
corresponding acceleration of the pulse renewed our
anxiety for the delivery of the poor sufferer, and
accordingly as vigorous efforts as could be made by
traction were undertaken, with, however, intervals
of rest. The head, still encircled by the os, was
The Medical Union.
99
speedily brought down from the superior strait into
the lower pelvic cavity ; and soon, by the united re-
sults of a dilatation per for z a of the os, and the
diminished size, or rather elongation of the head,
the head, and, speedily afterward, the whole body
of a male child was delivered. A slight palpitation
of the cord was perceptible, but all efforts, by
breathing into the lungs, rotation of the body and
external stimulation failed to effect a single volun-
tary respiration of the child. .
But immediate attention was demanded by the
mother. Immediately upon the withdrawal of the
chloroform, she recovered perfect consciousness,
asked if "the child was born?" "what was its
sex?" etc.
There was some retention of the afterbirth, and I
passed my hand immediately within the uterus, to
find it scarcely diminished in size, full of clots.
These I speedily swept out and easily removed the
placenta. The remainder of ^ii Ergot was then
given, ice passed into the uterine cavity, external
manipulation effected, and in short every means
adopted for this trying position within our power —
but in vain — the uterus had long been overdistended,
the tonic force was weakened by the albuminous /
condition of the blood. She had complained of
being powerless during the day, and now she felt
she was dying, and this expression, we could not
gainsay, although encouraging her by the state-
ment that " all was over."
Her breathing was now fearfully hurried, her
pulse scarcely perceptible. A dying request she
made to her heart-stricken husband, gave " her
love to her friends," thanked " you all (the doctors
and nurse) for their care" — a few labored breaths
and — all was over.
On hastily removing the clots and placenta from
the uterus, the firm nature of the entire mass of
clots evinced them not as the result of post-
partum haemorrhage, but assuredly as coagulations
from a long previous and concealed bleeding,
marking the case as one of ante partum haemor-
rhage. The supposed amniotic fluids, previously re-
marked upon, and which might have been suspected
by the rapid irritable pulse, and obliteration of
vision, were now accounted for — and which would
have been more than suspected, were not these
symptoms ascribed to the albuminous condition of
the blood and the flow due to the disruption, rather
than obliteration by stretching, of the muscular
fibres of the uterine neck.
Fortunately, in case this account of the symp-
toms might appear somewhat imaginative, among
the clots was found one so especially noticeable, even
when within the uterus, that I laid it aside for fu-
ture examination. It was some four inches long,
by three wide and two inches thick, of irregular
shape. (These dimensions were very variable in
its various portions, but are the limits of size.) This
clot was perfectly dry, every portion of attainable
moisture having been forcibly expressed from it.
On examination of the placenta, a portion ex-
actly corresponding to this clot, in size, commenc-
ing at the edge, was found wanting, and here was
palpably exposed the cause, after the albuminaria
of the peculiar symptoms of this remarkable case,
and if can now be tabulated and entered into the
book of our experience as one of ante-partum
h&morrhage. There were also two spots, of an inch
or more in extent, upon the placenta, black with
congestion and showing a diseased condition, pro-
bably like that whose fatal rupture caused the fatal
haemorrhage.
This examination and derivation has also another
satisfactory view (if we may be permitted such an
expression here), viz. : that in the medical and
surgical treatment there were no sins of commis-
sion, even less of omission. There was no un-
necessary delay, no whiffling or uncertainty — the
imminently dangerous character of the case was
early recognized, and every effort promptly made
to bring it to a happy conclusion.
To be sure one might censoriously say, " How
better off is she for the scientific skill she invoked ?"
It might be as well retorted, " How better off is she
for her prayers ?" — but we know the satisfaction
there is in every phase of life in doing right, one's
whole duty — the results are in better hands.
"Paul planteth, and Apollo watereth, but God
giveth the increase."
Society is apt to look at the irregular meals, the
broken rest, the bodily fatigues of the medical man,
and say his is a hard life, but it is the " wear and
tear " of mind and spirit of such cases as these that
sap the energies and exhaust the vitality. Un-
happy, indeed, is he who brings a weak mentality
and imperfect education to such a work. If, with a
conscience strengthened by a knowledge that he has
assiduously studied his profession, and that he has
neglected nothing to fit himself for the care of hu-
man life placed in his hands — if such an one is almost
overcome by the responsibility of his profession and
shaken to very intellectual and moral foundations
by such a case as this — how fearfully agonizing is
the remorse which must overwhelm the careless,
thoughtless man, to say nothing of the ignorant,
base pretenders — on reviewing such a case. "Is it
not thy brother's blood that crieth unto thee from
the ground."
I write these thoughts, knowing that many just
graduated students are now commencing a career,
entered upon as a means of support, or as a means of
doing good. I would that they may well think of the
responsibilities that they assume, and persuade
them to believe that the attainment of a diploma is
not the end of study, but the beginning of a life of
persistent thought and unending striving.
N. Y.. 237 East 13th St., Eastei', 1873.
NOTES ON THE TREATMENT OF SUB-ACUTE
AND CHRONIC CYSTITIS.
By John C. Minor, M. D.
Diseases of mucus membranes are peculiarly
obstinate when once they have assumed the chronic
form. The clinical history of leucorrhoea, chronic
nasal catarrh, and gleet, furnish sufficient evidence
to prove that chronic affections of the mucus mem-
branes are tedious and inveterate. Another pecu-
liarity of mucus tissues is the rapidity with which
they assume the chronic form of disease. These
characteristics prevail to a very marked degree in
the affections of the mucus lining of the bladder.
We frequently meet with chronic cystitis that has
never been preceded by any acute symptoms, and
a majority of the cases of sub-acute cystitis develop
rapidly, but disappear slowly. Partaking of the
IOO
The Medical Union.
general obstinate character of mucus diseases,
chronic and sub-acute cystitis are accompanied,
moreover, by peculiar pathological conditions which
render them in most cases extremely difficult to
cure. The intelligent and successful application of
remedies to these diseases requires a thorough ap-
preciation of the causes which produce and of those
which perpetuate the trouble. When we consider
the variety of these causes we can readily under-
stand why a merely routine practice is so uniformly
unsuccessful.
These causes and conditions, if considered with
any degree of fullness, would require more space
than would be practicable within the limits of a
single paper, and I must, therefore, refer to them
merely in their practical relation to the treatment of
cystitis. I have met with the sub-acute variety
oftener in women than in men. It is a very com-
mon accompaniment of fractures of the thigh ; so
common, in my experience, that whenever I am
called to a thigh fracture in a woman, I am rarely
disappointed in predicting its early occurrence.
These cases are due to a direct spinal lesion by
which the integrity of the spinal nerves and the
branches from the organic system which supply the
bladder is interfered with. We may, therefore,
refer the irritation of the bladder to sympathetic
action, provided we understand that the lesion con-
trolling the bladder is associated with the spine, and
not with the thigh or hip. The first symptoms of
trouble are generally developed within forty-eight
hours after the injury ; they are not usually severe,
and I allude to them merely as giving the basis for
a general consideration of the treatment of the
disease.
The power possessed by the bladder, in common
with other hollow organs, of preserving its contents
from undergoing rapid decomposition, depends upon
the integrity of its nervous supply. If this be in-
terrupted the vitality of the organ is impaired, and
the urine becomes susceptible of the same changes
as those which occur in it when removed from the
body. These changes are, in brief, the formation
of carbonate of ammonia and the precipitation of
the earthy phosphates. Thus we have the urine
rendered ammoniacal, and loaded with triple phos-
phates as the result of a spinal lesion. The urine
thus changed acts as a direct irritant to the mucus
membrane of the bladder, and its effect is all the
more injurious, because the vitality of the mem-
brane is depressed. Another effect of spinal lesion,
or rather a similar effect, is a loss of ihe natural
sensibility of the bladder ; the effect of this is the
secretion of unhealthy, alkalescent mucus, which,
acting chemically upon the urine, renders it alkaline,
and leads to the deposition of the earthy phosphates
(vide Curling Med. Ti?nes and Gazette, 1836, p.
325). Thus we find the urine acting on the mucus
membrane as an irritant, and the secretion from the
membrane acting as a ferment upon trie urine :
hence the pathological condition is one that repro-
duces itself, and accounts for the obstinacy of the
disease. In our treatment we may attack either
end of the trouble, but the best results are reached
when we treat both cause and effect.
When the urine is fetid, ammoniacal and irritat-
ing, the bladder should be frequently emptied by
the catheter, and syringed out with warm water.
This should be done every eight hours, and oftener
if required, the frequency of the operation being de-
termined partly by the irritating quality of the urine,
and, in part, by the amount of urine secreted. The
bladder should never be allowed to become distended
with urine, for the distension is not simply the re-
sult of paralysis, but a frequent cause of that con-
dition. These two indications, emptying the bladder
and washing it out, are of more importance than
any others in the treatment of sub-acute and chronic
cystitis. They are not required in acute cystitis so
long as the urine is acid or neutral. If the mucus
membrane of the bladder is ulcerated, or if there is
any traumatic lesion of the bladder or perineum, so
that the urine is brought in contact with raw sur-
faces, so long as the urine is acid it has no destruc-
tive action on the tissues, and may be absorbed
without any apparent bad effect. Operation wounds
moistened with fresh urine are not prevented from
healing by primary intention ; but the contact of
ammoniacal urine, even when filtered, will produce
abscesses and gangrene, and its absorption is fol-
lowed by profound disturbance of the whole system.
Hence, Prof. G. Simon has concluded {Deutsche
Klinik). that, in plastic operations on the urinary or
sexual organs, it is unnecessary to leave a catheter
in the bladder so long as the urine is acid, whilst
such operations should not be performed, if possible,
when the reaction is alkaline.
When the urine is ammoniacal, its frequent re-
moval and the washing out of the bladder are pro-
ductive of the greatest relief to the patient. I have
sometimes used medicated injections in these cases
with great benefit. Hamemelis, a dessertspoonful to
half a pint of water, is an excellent application to
use in this way ; but I think I have had the best
results from Cantkarides, from ten to thirty drops
of the tincture in half a pint of water. The use of
caustic injections, as recommended by Ricord, Ac-
ton and others, is injurious and ill-advised, and I
reject them entirely from a positive experience of
their dangerous qualities. I have been disappointed
in the use of carbolic acid as a topical application,
and can only recommend, from experience, the use
of warm water, and the two remedies above men-
tioned. My method of using these injections is
very simple. The urine is first drawn off by an
elastic (gum) catheter. I then attach an ordinary
"Davidson" syringe to the catheter, and throw in
half a pint of warm water. I withdraw the syringe,
and allow the water to escape through the catheter,
and then repeat the injection till the water comes
away perfectly pure without any urinous odor or
color. Then I throw in a medicated injection, if
required ; allow it to remain about three minutes
in the bladder, and then run out of the catheter.
About a teaspoonful of the injection will generally
remain in the bladder, which can be removed, if
desired, by converting the catheter into a syphon.
While we thus attend to the local condition of the
bladder, we may accomplish very much by the use
of remedies. Belladonna, Cantharis, Cannabis,
and Pulsatilla, are well-tried and efficient in many
cases ; but there are some others that deserve more
consideration than they usually receive in this con-
nection. For instance, in the form of sub-acute
cystitis, which I have described as occurring after
fractures, I have found Plumbum very frequently
indicated, and its use has often been followed by
very marked improvement. Capsicum is another
remedy which has given me great satisfaction in its
power to arrest some of the most distressing symp-
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101
toms that occur in all forms of cystitis. I use it very
often for the tenesmus and burning pain at the neck
of the bladder, and my experience with this remedy
has led me to expect its action suddenly if it comes
at all ; a single dose, when plainly indicated, appear-
ing to quiet the pain as rapidly as though a narcotic
had been given. Unless this remedy shows its
effect within a few hours, I do not wait long for its
action, but seek for another. When we meet with
retention of urine in the chronic cystitis of old per-
sons, not from paralysis, but from a spasmodic con-
traction of the sphincter of the bladder, Nux vomica
will generally relieve the spasm. When retention
occurs from paralysis of the muscular coat of the
bladder, rendering it unable to expel its contents, I
have never yet met with any remedy that seemed to
be of the slightest service, unless the bladder was
first emptied and prevented from distension by the
regular use of the catheter. When this indication
has been carried out I usually resort to the common
Tincture of Iron, from five to ten drops in water
three times a day. Although this may not be re-
garded as strictly homoeopathic treatment, it is among
the most valuable of my clinical experiences. It must
always be remembered that the use of the catheter
in this disease must be attended with the utmost
delicacy of manipulation, because the mucus mem-
brane is in such a state that it is easily abraded, and
likely to assume a serious condition from a compara-
tively trivial injury. Should any such injury occur,
Arnica is the remedy to use. This remedy is also
invaluable in the sore, bruised feeling that follows
the painful micturition of all varieties of cystitis. To
refer again to paralysis of the bladder, I may say
that Cannabis sativa has proved efficacious in this
condition according to the experience of others, but
not in my hands. Lithia is another remedy that
has produced good results in sub-acute cystitis, but
I have had no experience with it.
With reference to the action of Belladonna, as
applied to cystitis, I cannot do better than to quote
from an able paper, by Dr. R. Hughes, on the
"Action of Belladonna on the Urinary Organs."
{Brit. Jour. Horn., Jan., 1871) : "For simple irri-
tation of the bladder, short of actual inflammation,
I know of no medicine so valuable as Belladonna.
The pathology of the complaint is not always ob-
vious, but phenomenally it is well recognized. The
presence of bladder epithelium in the urine rather
indicates the medicine than otherwise ; nor need
obvious acridity of the secretion forbid it, whatever
be our accessory measures. The place of Bella-
donna in paralytic affections of the viscus is less cer-
tain. It is very useful in postpartum retention of
urine, but has yet to be tried in that which accom-
panies paraplegia. It is occasionally of striking
benefit in the nocturnal enuresis of children, but
quite as often utterly fails ; nor have I yet learnt
what is the form of the affection to which it is spe-
cifically suited. " Where the bladder alone is impli-
cated, I have rarely found this remedy of much
service ; but, when the kidneys are also affected,
either primarily, or from an extension of the dis-
ease, Belladonna is invaluable. Caniharis is more
especially adapted to the acute variety of cystitis,
but is very frequently indicated in the other forms.
Probably no remedy has been so thoroughly tested
in cystitis, and none has better deserved its reputa-
tion. Where there is frequent urging to urinate,
which is either ineffectual, or results in the flow of
but a small quantity, drop by drop, accompanied
with much pain -of an acute character, Cantharides
may generally be relied upon for prompt relief.
Want of space obliges me to merely mention some
other remedies, all well-known, such as Pulsatilla,
Dulcamara, Eupatorium purpureiun, Pareira
brava, Lycopodium, &c. With reference to the
selection of remedies by the observance of the color
and sediment, as classed among the urinary symp-
toms of the materia medica, I think it would be a
good thing for the materia medica if everything re-
lating to the color and sediment of the urine were
to be expunged from it. Theoretically these symp-
toms are totally unreliable, and practically they are
useless, and worse than useless, because they mis-
lead.
In chronic cystitis we must always give a guarded
prognosis, although there are some conditions, gen-
erally considered incurable, which are in my ex-
perience amenable to treatment. One of these con-
ditions is that of hypertrophy of the prostate, which
has repeatedly yielded in my hands to the adminis-
tration of Muriate of Ammonia, in doses of from
two to twenty grains of the crude drug in solution.
In cases of paralysis I have used galvanism with
benefit, transmitting the constant-current, by means
of a catheter-electrode, from the spine to the bladder.
The debilitated condition of most of these cases will
suggest the use of tonic doses of Iron. I have found
the Tincture of Iron best suited to the disease, but
in some cases I have used the Ammonia-Citrate of
Iron with advantage. Phosphoric acid is very gen-
erally applicable to these cases, especially where
nervous prostration is marked. I believe that stim-
ulants are generally detrimental, and I always use
the greatest caution in their use in this disease.
Kraus, of Vienna, says, speaking of this subject :
" Sparkling wines are very injurious in diseases of
the urinary organs, but not on account of their car-
bonic acid, which assists very materially in the
elimination of the phosphates. Champagne not
only increases the secretions, but, in an extra-
ordinary manner, the phosphates ; and the conduct
of medical men who advise its use in cases of calcu-
lus is very reprehensible." His experience abso-
lutely contradicts the idea of the solvent action of
carbonic acid in concretions already formed. Old
beer he considers unobjectionable ; but new beer is
to be avoided, as it increases the secretion of mucus,
and gives origin to a greater or less degree of catarrh.
English pale ale is open to the same objection;
porter, however, if of good quality and age, he con-
siders to be unobjectionable.
Poisoning by Strychnia Treated by
Chloral. — Dr. Turner relates the successful
treatment of a well-marked case of poisoning by
Strychnia with Hydrate of Chloral. The adminis-
tration of gr. xxx of Chloral was followed in thirty
minutes by a marked abatement in the severity of
the convulsions and improvement of vision. In
thirty minutes more a violent convulsion ensued,
which was entirely relieved by fifteen grains of
Chloral. Two doses more of Chloral were given on
the slightest return of the spasms, of gr. xxx each,
when the spasms entirely ceased. The muscular
soreness was mitigated by reduced doses of Chloral,
which was kept up until the soreness had subsided.
102
The Medical Union.
TWO CASES FROM DISPENSARY PRACTICE.
By J. Titus Deyo, M. D.
Being connected with one of our largest Homoe-
opathic Dispensaries, I have frequently an oppor-
tunity of treating and studying some exceedingly
interesting and instructive cases, such, indeed, as
are but rarely met with in private practice. From
the many such which have, from time to time, come
under my notice, I am prompted to give a brief de-
scription of two, which I look upon as of more than
ordinary interest. The first is a case of what I can
only define as one of Emotional Insanity. The sub-
ject was a man aged 45, an Englishman by birth,
but a resident of this city for many years ; tempera-
ment, bilious-nervous; occupation, blacksmith and
wheelright. Of splendid physique, his entire mus-
cular structure was well developed. His physical
health good, and all the alimentary functions per-
formed in a healthy manner. There was no organic
disease, hereditary taint, or particular dyscrasia ; in
fact the man was the very embodiment of physical
health.
His mental condition was as follows : A constant
fear of an impending evil (as regards himself). He
would be engaged at his forge, when suddenly, and
without any apparent reason, he would rush from
the shop under an apprehension that the building
was about to fall in and crush its inmates. In a few
moments this feeling would pass away, and he would
return to his work as if nothing had occurred, and
perhaps there would be no repetition of this par-
ticular manifestation of his malady for several days.
Another freak was, that in passing along the street
to and from his work, sometimes even when ac-
companied by one of his fellow workmen, with whom
he might be at the time engaged in a pleasant con-
versation, he would, in a twinkling, wheel to his
right or left, and rush precipitately to the opposite
side of the street, fearful that some one, concealed
in one of the houses he was passing, was about to
hurl down upon his head some sort of a missile ; or
in passing an open door-way or alley-way he would
hasten his pace or immediately betake himself to the
middle of the thoroughfare in order to be out of
some fancied harm's way.
At home, while in the society of his wife and
family, this singular aberration of mind showed itself
in a somewhat analogous manner. Constantly in a
state of apprehension lest some one should gain ad-
mission to his apartments and do him bodily injury,
he took extra precautions that his windows and
doors were doubled-locked and barred at retiring.
Another eccentricity .was his strong objection to
having newspapers, books, or printed matter of any
kind about the house, lest they might contain a de-
scription of some murder, suicide, robbery, or
criminal act. On several occasions his eyes hap-
pened to rest for a moment on a cut in one of the
illustrated weeklies, representing an atrocious mur-
der— in a sufficiently vivid style to satisfy the most
morbid appetite, and the effect produced on him,
simply by a glance at these pictures, was to throw
him into a condition approaching convulsions. As
a consequence, everything of this character was
carefully kept from his sight by his family.
The subject of a murder, suicide, or anything of a
kindred nature, if mentioned in his presence, in-
fluenced him in a like unhappy manner. No act or
word of his had ever given his family or friends
reason to suspect that he harbored any idea of doing
any injury either to himself or them ; his actions,
beyond such as I have mentioned, were unexception-
able. His family consisted of his wife and several chil-
dren, two of whom were grown up, for all of whom
he entertained the greatest respect. From youth
up he had led a most exemplary life — industrious
and economical — eschewing entirely the use of
liquors or tobacco in any form. He had always en-
joyed excellent health ; had never had typhoid or
typhus fever, which sometimes predispose to this
condition of mind, nor ever received any injury
whereby the brain might have become affected, nor
could he, or any of his family, recall to mind that
he had ever any severe mental or nervous shock.
No insanity of any type had ever manifested itself in
his ancestors, on either side, for at least two gene-
rations. He could sit and converse on any given
subject, except the aforementioned, rationally and
intelligently, and would acknowledge the fact that
the weakness he showed was a most foolish and
ridiculous one, yet he was totally unable to control
his actions under the several circumstances enum-
erated.
Such was the condition of the man when I first
saw him, as I ascertained in part from him at the
time, and subsequently more in detail from his wife
and daughter.
He had been afflicted with this trouble for some
four or five years ; manifesting itself slowly and not
fully developing itself for at least eighteen months
after its commencement. As soon as he became
cognizant of his malady, he placed himself under
medical treatment and faithfully followed up the same
for at least a year and a-half, but with no perceptible
benefit. Becoming discouraged he gave up treat-
ment altogether.
He passed the dispensary daily in going to and
from his shop, and was prompted to step in one
noon to be prescribed for, for some minor trouble,
and the subject of his disease being uppermost in
his mind, he was impelled to state briefly his case,
and inquire of me as to whether there was a proba-
bility of his being benefited by placing himself
under Homoeopathic treatment — volunteering the
statement, that for some time past he had been
seriously considering the advisability of entering one
of our various asylums which make a specialty of the
treatment of diseases of the nervous system. I dis-
suaded him from taking any such course, at least for
the present, promising him that I would look into
his case thoroughly. In the course of a week he
called on me a second time, and having in the mean-
time studied his case, I was firmly convinced that
his mental ailment could be ameliorated, if not
entirely removed by medical treatment. I, there-
fore, had no hesitation in so assuring him, pre-
facing this assurance, however, with the statement
that it would possibly be months ere a complete
recovery could be brought about.
The treatment adopted in this case was as fol-
lows : I looked most carefully through my Materia
Medica, and chose but two remedies, Aurum Muria-
ticum and Hyoscyamus Nige?% and kept him
steadily under them for about six months, with now
and then an intermission of a week without any
medicine. There was a perceptible change in his
condition within six weeks from the commencement
of treatment, and he continued to improve until, at
The Medical Union.
103
the expiration of a half year, he came to me and pro-
nounced himself entirely cured ; being unable to find
language sufficiently adequate to express his grati-
tude. During the last six or eight months I have
lost track of him, but at last accounts he had had no
return of his malady.
Case 2. — An American woman, aged 57, mother of
seven children, the youngest of whom was 15, years
of age ; had never aborted ; had always menstruated
regularly during the proper periods ; passed the
climacteric period at the age of 47 ; no signs of any
recurrence of the menstrual function from that time
until, at the age of 56, she noticed what appeared to
be a menstrual discharge lasting two days ; no par-
ticular attention paid to this, as she had been sub-
jected to considerable physical labor during the
preceding few days, and to this cause was ascribed
the anomaly. This occurred a little over a year
ago. In August last she came to the dispensary
desiring treatment for what had been diagnosed as
dropsy. Was subjected to a physical examination by
one of our medical staff, who had no hesitation in
pronouncing it a case of ascites. She was placed
under treatment which was continued for about a
month without effect. She then went to the Col-
lege of Physicians and Surgeons, and was examined
by several of the faculty, their opinions differing as
to whether it was . a case of ovarian dropsy or hy-
datid formation in utero. About a month subse-
quently she visited the dispensary again, and for the
first time came under my notice.
The case excited my interest, and I made a most
thorough examination, and diagnosed pregnancy —
although with some misgivings as to the accuracy
of my opinion, owing to its variance with the ex-
pressed opinion and judgment of older and more ex-
perienced physicians.
I did not see her again until the early part of last
winter, when she presented herself to me with an
infant scarcely a month old in her arms ; asked me
if I recollected her, and on answering her affirma-
tively, held up the child, saying, "Here, doctor, is
the dropsy I had last summer /"
CASES FROM PRACTICE,
By William N. Guernsey.
In my article, " The Treatment of Skin Dis-
eases Surgically Considered," in the April number
of the Union, I was compelled, from want of space,
to omit reports of cases illustrating the views which
I there advanced.
Case i. — Eczema Capitis, acute. — Mrs. M.
brought her infant, aged eight months, to the clinic
on diseases of the skin at the New York Western
Homoeopathic Dispensary on Nov. 13th, 1872.
The disease appeared for the first time about two
weeks previously. The mother said at that time
the child was restless and fretful, and, on examining
the child, she noticed a small portion of the scalp
was red and inflamed, and covered with small
"water blisters" about the size of a pin's head.
These, after remaining a short time, burst, and
left a raw, inflamed surface. The inflammation
extended, new vesicles were continuously formed,
and their exuded contents were massed in gummy
crusts.
The appearance at the time of application for
medical aid was as follows : nearly one-half of the
scalp was reddened, tumefied and thickened; its
surface was moist, and covered here and there with
patches of yellow crusts. The disease was not
limited to the hairy portion alone, but extended on
to the forehead and over one ear. The latter was
greatly swollen, and covered with a serous exuda-
tion, and the inflammatory process was extending
itself into the auditory canal. The suboccipital
and cervical glands were greatly swollen. The pa-
tient's general health seemed good.
I ordered a flannel nightcap to be made and to
be worn, saturated with sweet oil, for the following-
night ; the next morning the affected part to be care-
fully cleansed with castile soap and tepid water, and
then benzoated oxide of zinc ointment to be ap-
plied.
On the 1 6th inst. the patient was returned greatly
improved. The surface was free from scabs or
crusts, and nearly dry, the tumefaction much di-
minished, and the reddening had nearly subsided.
The treatment was ordered to be continued, and
the patient to return in a couple of days.
Nov. 1 8th. The patient returned, showing only a
reddish blush on the site of the previous eruption.
This quickly disappeared, and within one week
from the commencement of the treatment the child
was restored to perfect health.
As the child's health, at the time of treatment,
seemed good, no internal treatment was given.
The disease seemed at the time to have limited
itself as a local inflammation. Situated on the scalp,
the eruption was increased and aggravated by the
conditions of the tissues on which it rested. As the
hairy scalp is the seat of large sebaceous glands, its
secretions mingle with that produced by the disease
and from crusts which have very irritating properties.
These, under the influence of air and moisture, decom-
pose, and initiate, or, at the least, favor an extension
of the inflammation. By removing these, the irrita-
ting causes were taken away, and nature allowed a
fair chance to act. By means of the ointment the
air was excluded, the burning and itching relieved,
and a slightly stimulating action established — and
thus the indications of an acute local inflammation
were met.
This case presents nothing peculiar ; it is one of
a class which is commonly met at the dentition
period.
Being instigated and concomitant with the evolu-
tion of the teeth, usually the more prominent symp-
toms of the dentition process are treated with a
view that with the removal of the cause the disease
itself will disappear.
Although the disease of the skin is acute in char-
acter, and of short duration, it had become, to a
certain extent, a local affection, and required topical
applications. As catarrhs of the mucus membranes
require treatment after the removal of their
causes, or the restoration of the general health from
the disease which developed them, so may we be
guided by the same principles of treatment in the
management of the catarrh of the skin, viz. : of
eczema.
Case 2. — Eczema Iinpetiginodes. — Kate W.,
aged twelve, applied last December to me for medi-
cal aid. She was suffering from an eruption on the
head, she said, which she had first noticed about
three weeks previously.
!04
TJic Medical Union.
On examination I found the hair matted over the
occipital region, and the skin covered with thick,
dirty, yellow crusts. Around their borders were
groups of vesicles and pustules dispersed over a
highly reddened and tumefied skin. She had a
large head, a clear skin of remarkable whiteness,
through which the delicate blue veins could be
easily traced — large, blue, languishing eyes, and
other anomalies which go to form a complete pic-
ture of scrofula.
The suboccipital glands were swollen, the mus-
cles were soft and flabby, and all the functions of
the body seemed to be imperfectly performed.
I ordered the hair to be cut over the affected por-
tion of the skin, and the crusts to be removed with
dressings of oil. Also nux and heftar stdphuris to
be given internally.
After an interval of two days, the patient returned
somewhat improved in general health. The crusts
had not been entirely removed, and the same dress-
ings were ordered to be continued. Three days
afterwards she returned much improved. The
crusts were all removed, and the swollen glands
diminished in size.
The appetite was improving and digestion more
easily performed. Ordered the benzoated oxide of
zinc ointment to be applied, and the internal treat-
ment to be continued. She then speedily re-
covered.
Here also is a case of a class of diseases most
commonly met in practice.
In this instance the treatment adopted was ex-
tremely simple. The digestion was attended to ;
easily digested, plain, substantial food was freely
given. The skin was kept active : sponge baths,
exercise in the open air, and such other means used
as would give a healthy tone to the system.
Case 3. — Acute Eczema. — About a month since
Mrs. L. brought her child, an infant of seven months,
to. me for treatment.
The forehead, a portion of the face, and a little
of the scalp were oedematously inflamed, and
covered with clear watery vesicles. The child was
restless and fretful, and there was evidently much
burning and itching present.
The eruption had made its appearance three
days previously. The appearance of the skin re-
called to my mind the effects of the poison ivy, the
rhus toxicodendron. The case before me was an
acute one, the part was in a state of active in-
flammation.
If any applications were to be made, they must be
cooling, and soothing, and such as would lessen the
inflammation.
As the analogy of -this case, and the eczema pro-
duced by rhus tox was so complete, I prescribed
the latter remedy. Three days afterwards the
child was returned, and only a slight reddish blush
served to indicate the previous eruption. The
treatment was continued, and as the case did not
appear again I concluded that it was cured.
I give this case to show the benefit of internal
treatment. Acute eczema, like other acute diseases,
often runs a short typical course. Then if medicine
be given to mitigate the severity of the symptoms,
and guide it in a proper course, it may, like acute
bronchitis, have a typical form and ending. The
law that all acute diseases tend to spontaneous re-
covery holds good in eczema — as in bronchial or
intestinal catarrh. Exposed to many sources of
irritation its course is not so cyclical, however, and
a happy termination in speedy recovery less fre-
quent.
Case 4. — Chronic Eczema. — Mr. F., a laborer,
aged thirty-five, presented himself last October to
my clinic at the dispensary for treatment. He
said that he had an eruption on his leg for two or
three months. He first noticed, that the skin over
the tibia was hot and reddened and covered with
fine " water blisters. " He had been under con-
tinuous treatment with several physicians, but had
steadily grown worse.
When I first saw him, the eruption extended over
•the lower two-thirds of the anterior portion of the
leg. The skin was reddened, much thickened and
infiltrated, and covered with dry scales. He said
that he had taken arsenic and numerous other
remedies;, but no external treatment had been made
use of.
The man seemed strong and healthy, and tem-
perate in his habits. I ordered the limb to be
wrapped up with flannel, saturated with oil, con-
tinuously for two days. At the expiration of that
period, I found the skin free from scales, and I
ordered safto viridis to be rubbed on twice daily,
with a piece of dry flannel, until the part looked
bright red, and shiny. Under this treatment he
improved rapidly at first, but after four or five days'
application the part became hot and irritable, and
the benzoated oxide of zinc ointment was applied
instead. Three days afterwards, as the irritability
had subsided, and the infiltration had very con-
siderably disappeared, I renewed the applications of
the green soap, which were continuously applied
during the rest of the treatment. Within three
weeks after his first appearance at the dispensary he
had entirely recovered. In chronic infiltrations of
the skin, the potash, and the iodine which is con-
tained in the cod-liver oil of the sapo viridis, stimu-
late the skin favorably, and promote absorption. In
ordinary cases the potash combined in a soap acts
better than when used alone in a solution of water.
Case 5. — Psoriasis. — In the summer of 1871,
Mrs. C, aged about forty years, applied to me for
treatment. She had been suffering with an erup-
tion for four years or more, and being somewhat
vain, it annoyed her exceedingly. I found dis-
persed on the extensor surfaces of the extremities,
and on the neck and trunk, groups of masses of
scales situated upon an indurated and reddened skin.
The scales were piled in masses as large as a cent
piece and upwards, and were of a mother-of-pearl
color. They could be easily removed with the
finger nail, which, when done, showed a reddened
corium underneath. It was plainly a severe case of
psoriasis.
Her last physician had prescribed arsenicum for
her, which I continued. I then ordered one of the
extremities to be covered with oil dressings for
twenty-four hours, then, after the removal of the
scales, the oil of cade to be applied with a stiff
brush. After an interval of two days another por-
tion of the body to be treated in the same manner.
Only a limited portion of the body was subjected to
this tar treatment at any one time, that constitu-
tional symptoms might be avoided. The method
of treatment was somewhat irksome and disagree-
able to her she said, but bore it willingly as she
saw the steady improvement of the disease.
The Medical Union.
[05
This plan of treatment was continued for six
weeks, when it was discontinued. Nearly all of the
psoriatic patches' had disappeared, and only faintly
reddish spots were left of those remaining.
Tar is very serviceable in psoriasis and in chronic
eczema. Its action is that of a local stimulant to
the skin. It relieves the itching, checks the secre-
tions, and promotes the absorption of the infiltra-
tions. It is used very extensively in Hebra's wards
in a variety of methods. A favorite one is to apply
the tar with a stiff brush, rubbing it in with con-
siderable force, and then to take a bath for a couple
of hours. Baths are also used extensively as a part
of the regular treatment of skin diseases in the
Vienna hospital. The prolonged action of the
water macerates the crusts, softens the affected por-
tions, and promotes a healthy flow of blood through
the parts.
According to the best authorities arsenic will cure
light forms of psoriasis, and in this disease it has
won the laurels which have given it such a wide-
spread reputation as a specific for scaly eruptions.
When taken in toxicological doses it produces an
inflammation in the healthy skin, which manifests
itself as a psoriasis. According to the law of
"similia similibus ' I prescribe it in all cases of
psoriasis, as under its use the formation of the scales
is diminished and "the efflorescences fade.
Carbolic acid is worthy of mention here, as for
the past few years it has been fashionable to pre-
scribe it in washes for nearly every form of skin
disease. It is a valuable remedy in certain condi-
tions of some of these diseases, but almost useless in
many others in which it is ordinarily prescribed.
In chronic eczema, erythema, and in psoriasis it
may be efficaciously used where tar is indicated, but
inadmissible from the location of the eruption — as
on the hairy or exposed portions of the skin.
Its curative action is not so marked, however, as
that of tar.
I will add another case to show the results of its
use:
1
Case 6. — Eczema Capitis. — Miss M., aged
twenty- two, a blonde, applied to me some months
since for medical aid. She had an eruption on the
head, which first attracted her notice about a year
previously. Patches of eczema were scattered
over the hairy portions of the head, which,
aside from the unpleasantness of its pres-
ence, was exceedingly annoying from the excessive
itching. The chain of glands underneath the
chin and behind the ears were considerably swollen.
She frequently suffered from attacks of catarrhal
bronchitis, which were developed on the slightest
exposure. It was plainly evident that she had a
scrofulous temperament. I prescribed the syrup of
the hypophosphites of soda, lime and iron, and
ordered the crusts to be removed with oil dressings.
As she was one of fashion's votaries, and seen much
in society, to cut off the hair, or apply greasy or
tarry substances was out of the question. So, after
the crusts were thoroughly removed I ordered a car-
bolic acid wash to be used night and morning. Four
days afterwards she returned. The itching had sub-
sided, the skin was pouring out but little secretion,
and the glands were much diminished in size. Her
general health seemed improved, and the treatment
was continued. Again in four or five days after-
ward she returned somewhat better, but as the
improvement seemed slow to her I changed the acid
wash for the following mixture :
r> Sapon. viridis, ^ij.
Aquae Cologniensis, 3x.
Misce et cola.
It was only used for a couple of days, however, as
it was more inelegant than a wash, and the carbolic
acid was again resumed. The soap had stimulated
the scalp considerably, and now recovery occurred
speedily. Within two weeks the glandular swellings
entirety subsided, and the eruption almost entirely
faded. Carbolic acid may be used in solutions vary-
ing in strength from two to twenty grains to the
ounce of water. In this case the internal treatment
contributed, without doubt, greatly to the rapid re-
covery.
VITAL STATISTICS FROWI THE NINTH CENSUS.
By W. S. Searle, M. D., Brooklyn, N. Y.,
Ophthalmic Surgeon to the Brooklyn Homoeopathic Hospital.
Volume second of the ninth census of the United
States lies before us, and is a most valuable and in-
teresting compilation, not to statisticians and pro-
fessional men only, but also to the community at
large. As the number of copies printed is quite
limited, and the work may, therefore, fall under the
eyes of but few of our readers, we call attention to its
leading points of interest, remarking that reference
to the book can be had in any comprehensive pub-
lic library in the country. The entire volume of
nearly seven hundred pages, quarto, is occupied by
vital statistics.
The feature of most striking public interest will be
found in the maps and charts. Some of these are
so tinted in five different shades of the same color as
to report instantly to the "eye the prevalence of a
given class of diseases in the various sections of our
country. Each shade of color represents a per cent.
of mortality which is stated upon the margin.
Thus, the first map gives us at a glance the rela-
tive frequency of consumption. Others graphically
mark out the regions where malarial diseases, typhus,
typhoid and enteric fevers, diarrhoea, dysentery and
enteritis do most and least abound.
A comparative study of these maps reveals many cu-
rious facts upon which we cannot here dilate. We may,
however, remark the striking absence of consump-
tion where malaria is most abundant, and vice versa,
as showing an apparent antagonism between the
conditions favorable to each of these forms of
disease.
It has lately become the fashion to speak of south-
ern California as a paradise for consumptives. Nord-
hoff and other travelers have recommended this
climate to such invalids in the highest terms. But
with no little astonishment we find the valley of
the Sacramento stained to the very deepest tint of
blue upon the map, thereby denoting that over one-
fifth of all the deaths in that locality are from this
dread disease. The San Joaquin Valley is but a
shade better, and even the region which includes
•Santa Barbara and San Diego furnishes 900 to 1,400
deaths from consumption in the 10,000 from all
causes. This rate equals that of Westchester and
its adjoining counties in this State. Before this logic
of figures the glowing descriptions of chance ob-
servers must go down.
io6
The Medical Union.
According to the map there are but four regions
east of the Mississippi where the deaths from con-
sumption are less than 250 in 10,000 from all causes.
Of these the most extensive is in Florida. Another
comprises Middle Georgia. Still another small sec-
tion lies in and near Burke Co., N. C, and a fourth
in southwestern Virginia, near the famous sulphur
springs of that locality.
It is singular that, with the exception of Florida,
which is devastated by malarial and intestinal dis-
eases, and becomes uninhabitable in summer for in-
valids, neither of these regions has been a favorite
one with the medical profession as a sanatarium for
consumptives. The truth is that climatal quackery
is quite as common as quackery in drugs. Self-
interest, or prejudices based upon inaccurate and in-
complete data, move men to select some locality and
write it up as the most healthy on earth ; and thither
flocks poor, sick, credulous humanity only to find a
grave.
So far as we can judge from these maps, the
region of the upper waters of the Kanawha and the
Sweetbrier rivers, in and about the famous springs
of southwestern Virginia, is the most healthful in all
respects that our country affords. No locality is
more free from malarial and phthisical influences,
while, in respect to all the other forms of disease con-
sidered in the census, it ranks above the average in
point of immunity. Its elevation is from 2,000 to
4,000 feet; the mean annual temperature is 520,
and the rainfall is about 40 in. In nearly all these
respects it is superior to Florida or either of the
above-named places where the mortality from
phthisis is low, and, unless the census data are
grossly incorrect, it is the place of all others whither
physicians should direct the multitudes who are
seeking to escape death from consumption.
Aiken, S. C, a much vaunted locality, ranks be-
low it in all respects.
In this volume charts are also given showing the
elevation, temperature and rainfall of various sec-
tions of the country. These are very minute and
accurate, being based upon observations directed by
the eminent scientists of the Smithsonian Institute
during the past twenty years.
To the physician and the invalids under his care,
to summer tourists, and to all who would know
whether they are living in climatal conditions most
favorable to their peculiar temperaments, or who
are intending to emigrate to new homes, these
maps and charts are priceless. They should be re-
printed in a volume for general distribution, or in
some way be made accessible to every citizen.
If we may trust these statistics of mortality which,
confessedly, have been completed only by estimated
correctness, the average duration of human life in
this country is much higher than has been generally
supposed. It is set down at thirty-nine and a quar-
ter years
This estimate is founded upon the actual death re-
turns made by the census marshals, to which are added
forty-one per cent, for supposed deficits and errors
The tables giving the mean future duration of
life at any given age are open to similar objections.
These vary somewhat from similar tables now ex-
isting, are somewhat lower than most, and cannot,
by reason of their possible inaccuracy, be of much
value except so far as they confirm the general aver-
ages by which life-insurance has hitherto been reg-
ulated.
In conclusion we may quote some of the more in-
teresting statistics contained in this volume.
The total population of the United States is about
thirty-eight and a quarter millions.
Total number of deaths in the current census year
— 492,263, or about 1,349 per diem.
March seems to be the most fatal month, leading
any other by about 1,000.
March, April and May form the most fatal quar-
ter, exceeding any other three consecutive months
by over 13,000.
The births number 1, 100,475, or about 3,000 per
diem.
The blind number about 20,000.
The deaf and dumb, about 16,000.
The idiotic, about 24,000.
The insane, about 37,000, nearly one third of
whom are, of foreign birth.
Persons over 80 years of age number about 1 50,000.
" " 90 " " " - " 7,000.
" " 100 " " " " 3,500.
Of those over 80 years, the females out-number
the males by about 12,000.
Of those over 90 years, the females are in excess
by about 1,200.
Of those over 100 years, the females exceed the
males by about 1,000, and the former are nearly
twice as numerous as the latter.
HYDROPATHIC TREATMENT OF TYPHUS
FEVER.
By C. C. Schieferdecker, M. D.
In this article I shall omit the etiology and
confine myself simply to the hydropathic therapeu-
tics of typhus.
The general indications for the treatment of ty-
phus are these :
1st. Protection of the brain and nervous system
from the combined influence of the poison and the
increased temperature of the blood.
2d. Limitation of this influence, and thus pre-
venting degeneration of the blood.
3d. Obviation of the early formation of the ty-
phus product.
4th. Preservation of the strength of the patient,
and diminish waste.
5th. Prevention and removal of local difficulties.
6th. Arousing and strengthening the skin for the
final excretion.
A properly applied bath combines a reviving, anti-
febrile, derivative and strengthening effect, which
may be graduated at pleasure, from a simple, slight
ablution, to short wet-packs, half-baths, plunge-
baths and affusions, sprinkles and douche. Brand
says, " In the rousing of the brain and nervous sys-
tem by cold water, and in the reaction caused by
it, we perceive the reason why the functions of
these organs are restored. It counteracts the de-
pressing effects of the poison, by constant stimula-
tion, and keeps the temperature of the blood within
proper limits.
General rules of the water treatment :
A. Diminished temperature by affusions is some-
what counteracted by reaction.
B. The affusions need not be constant, but
frequently repeated, and for short periods.
C. The colder the water, the more intense the
The Medical Union.
107
effect of the affusions. When the nervous irri-
tability is great, a middle temperature (from sixty
degrees to seventy-five degrees F.) produces a
decided effect.
D. Too cold water is injurious, and too warm
water produces but indifferent results.
E. We may, in early stages, use colder water than
later in the disease.
F. The warmer the patient was before the bath,
the more pleasant is the affusion.
G. The greater the surface of the body exposed to
the affusion, the greater the reactionary effect.
H. Affusion on the head — the body being in a
warm bath, or covered — produces only a local and
slight effect.
I. The shorter the affusion the more transient
the effect, but a too long bath exhausts.
K. The bath must be repeated as soon as the ef-
fects of the preceding one disappear. In the early
stages this occurs much sooner than later in the dis-
ease.
L. The greater the weakness of the patient, the
stronger the effect and the higher must be the tem-
perature of the water.
M. Under all circumstances the general condition
of the patient must be taken into consideration.
N. Thorough wet rubbing increases the effect of
the affusion, and assists in restoring the equilibrium
of the nervous system.
O. The affusion acts, at the same time, as a pow-
erful tonic.
P. Affusions may be applied during the whole
course of the disease.
The excretions of the skin, in typhus, are decid-
edly critical, and, therefore, the skin should be thor-
oughly and repeatedly rubbed with wet hands.
Drugs, or any substance which taxes the digestion
to any great extent, should be prohibited ; as the
digestive apparatus already suffers from feverish ex-
citement.
Affusions must be combined with ablutions, half-
baths, or packs, to reduce the temperature according
to the momentary necessities. The reduction of
temperature must be the constant aim, so as to
prevent changes in the blood — care must be observed
not to get it too low, as there is as much danger in
one extreme as the other. By these means the
pulse is moderated, the nerves quieted, sleep pro-
duced, the secretory organs incited to action, and
the temperature of the blood kept within proper
limits.
Generally, affusions alone, in or out a half-bath,
if properly continued and repeated, are sufficient
to attain the desired results. The patient ought to
drink a large quantity of water, breathe pure and
fresh air, be kept scrupulously clean as to clothing
and bed, be very lightly covered and be confined to
a simple, cool diet, and apply cold compresses
wherever needed. If the patient is very feeble, we
give the affusions while he sits in a tepid half-bath.
We must not wait to repeat the treatment for a de-
cided exacerbation of the symptoms, but aim to
prevent any such increase by prompt action.
The treatment above mentioned, scientifically
applied, is all-sufficient, and I believe will cure a
larger per centage of patients than any other.
But unscientifically used, water is capable of doing
serious harm. I strongly deprecate the haphazard
use of water in any disease, and consider the use of
ice and icewater, as recommended by.some authors,
as cruel and exceedingly dangerous, and hydro-
pathy should not be made responsible for such errors
in judgment. The theory and practice of hydro-
pathy are fully considered in a work I am about to
have published, and to which I would like to direct
the attention of the profession.
A LETTER FROM VIENNA.
Vienna, March 25, 1873.
Dear Union — In a former letter I promised on
a future occasion, to describe more fully some of
the internal workings of the Vienna School of Medi-
cine ; that occasion now presents itself, and hence
this communication.
We are now in the midst of the Easter vacation,
during which the University lectures cease, and, to
a certain extent, the private courses, so that the
clinics constitute the principal attraction to the
student. As Billroth's Clinic is perhaps better
known, at least by name, among us at home, than
any other here, a short account of it may not be
uninteresting to your readers.
A little before 9 o'clock in the morning, as we
enter the gate of the Allgemeines Krankenhaus, we
notice a number of men coming singly or in little
squads from all directions, and wending their way
towards their various fields of study. A large part
of them seem tending towards that archway over
there to the left; there, we know, Billroth's wards
are to be found, and under the arch is the entrance
to them and to the clinical theatre. Following the
rest, we mount the stairs one flight, make our way
through a small door and a narrow, dark passage
with a slanting ceiling, which indicates that we are
passing under the operating room, and find our-
selves at once in the latter. The " Klinik-saal " is
the same familiar room we have in our own hos-
pitals and colleges at home, with its open circular
arena in the middle, almost surrounded by semi-
circular rows of wooden benches, each row higher
than that in front of it. The room, we should say,
is about fifty feet square, capable of holding (stand-
ing and sitting), about two hundred persons. As
the hospital clocks strike the hour of nine, the stu-
dents come hurrying in, and their appearance,
individually and collectively, arrests at once the
attention of the new-comer. Collectively, they are
a rough lot ; and individually, their souls are evi-
dently very much above such trifling fopperies as
the use of soap and comb. Scrupulous neatness of
person is popularly supposed to be incompatible
with true genius, and hence, (although we are un-
aware of any other reason for so doing), we are
inclined to accord to the genius of Austrian medical
students the very highest rank.
For a few minutes there is a great scrambling
and noise until all the genii are seated, and then a
side door is opened by a servant in livery, and, at-
tended by half-a-dozen assistants and several female
nurses, Professor Billroth enters. Giving a few-
directions to his assistants, glancing an instant over
his stand of instruments and another at two or three
patients who have been brought in, he stops at one
end of the operating table, and, for the first time
since entering the room, looks slowly, half uncon-
sciously over the class, while a patient climbs into
position on the table, and the class becomes quiet.
A man of middle height and middle age, or per-
io8
The Medical Union.
haps a trifle more he seems, with figure rather
portly for such an active worker, high, broad, gently
retreating forehead, marked with lines of thought,
and from which the slightly-silvered brown hair is
combed directly back; eyes of gray blue which,
aided by the habitual contraction of the brows, have
a way of shrinking behind the lids as though they
feared the light; and finally, prominent, slightly
aquiline nose, and grayish-brown full beard, cover-
ing the lower half of the face and descending to the
breast, which adds a dignity and strength to the
already serious, thoughtful, modest face of the great
teacher.
While the patient is being brought under the in-
fluence of Chloroform (Ether sulph. is never used),
the professor gives the class a concise history of the
case — caries of the elbow joint ; goes as far into the
pathology of the disease as time allows, and de-
scribes, and gives his reasons for performing the
operation he has decided upon — resection. Mean-
while, we note the unnecessarily large number of
assistants in the arena, including nurses, some eight
or ten, and the fact that, excepting the first and
second assistants, who occupy of course the posts
of honor, they seem to have no regular, individual
duties to perform, but pass sponges, instruments, or
look on, according as each is inclined. The patient
anaesthetised, and the professor duly arrayed in his
operating gown, the performance begins — and such
a performance as never is seen by us in America !
The first incision is the signal for a general crowd-
ing of the assistants around the operating table, to
the perfect shutting out of all view of the case,
except when an assistant backs out of the crowd to
get some forgotten instrument, and we see by dint
of standing on the back of a seat, that blood has
been shed. A sawing sound then ensues, and the
crowd scatters right and left, allowing the half-suffo-
cated operator to make his way out. " A splendid
operation ! " of course ; Billroth has performed it !
It is well that Billroth's reputation has a much
firmer foundation than the discipline and order dis-
played by the mob who assist him. I do not allude,
of course, to the well-trained first, second, or third
assistants, but to those who have more recently
come from the ranks of the genii before mentioned,
among whom we sit.
This crowding about the operating table was re-
cently carried to such an extent that a female patient
was actually pushed off on the floor — and had to be
lifted again into position. The professor, even
then, rebuked no one, but he certainly must have
thought a " Donner wetter " or two.
Next, we have the satisfaction of seeing a felon
opened. Then a case of stricture of the esophagus
rather rudely (it seems to us) dilated. Then ampu-
tation of the index finger, a circumcisio penis, and
a few other such operations which we are rather
surprised to see in a " great " clinic like Billroth's—
and "see" them we do, for they are not rare
enough to warrant the mobbing by the assistants,
already described. Then comes a man into the
room without a nose, and after a few minutes goes
away with one — a very good one too — taken from
his forehead. This we have also seen, on account
of the patient having been held in a sitting position.
Then follows an amputation of the arm, on account
of a crushed and gangrenous hand and fore-arm.
Then an amputation of a cancerous breast, includ-
ing the extirpation of the chain of glands, which are
followed thoroughly, well up into the axilla, leaving
an ugly wound and a doubtful prognosis, as the pa-
tient is old and somewhat feeble. Finally, the right
inferior maxilla is removed, on account of necrosis,
and from the appearance of the top of the profes-
sor's head, which we occasionally see rising above
the ring of assistants which surrounds him, we
know at once that the operation is performed in
his best manner. Eleven o'clock sounds from the
big, old-fashioned clocks of the hospital, it is time
for us to go to our laryngoscope, and regretfully
and on tip-toe, we leave the presence of Billroth,
his assistants, and the " great Unwashed." '
It is a remarkable fact that anaesthetics are given
here only in protracted, capital operations— such as
amputations, resections, &c. A patient under-
going such operations as circumcision or ampu-
tation of' the penis, removal of fatty tumors, ex-
tensive cauterizations, and the like, is usually not
anaesthetised. Amputations of fingers and toes are
not infrequently performed upon the conscious sub-
ject. Even where anaesthetics are used, it is usually
only to such a slight extent that the patient
recovers consciousness about the middle of the
operation.
The only reason we have ever heard given for
this disregard of the comfort of the patient, is the
cost of the Chloroform. M.
The Alumni Association of the College of
Physicians and Surgeons are making an effort to
raise one hundred thousand dollars for the purpose
of endowing an Alumni Professorship of Patholog-
ical Anatomy in the college, and the establishment
of separate laboratories where students may learn
chemistry, physiology, and pathological anatomy
experimentally, and where original researches may
be carried on, under the guidance of competent
instructors, and the erection of one or two small
recitation rooms capable of seating about thirty
persons. By taking this course, the Association
believes a large number of students who now seek
that practical instruction, so necessary in this age of
scientific improvement, in the great hospital and
among the world-renowned specialists in Vienna,
can be retained in our own country.
While they are in the way of improvement, we
suggest that they copy a little of the liberality and
freedom from sectarian bigotry and intolerance
which we find in the European Universities. In
these days of scientific advancement, no institution
can reach eminence controlled by the narrow and
unscientific spirit we so often see in our medical col-
leges. Students will seek instruction in institutions
controlled by a broader spirit, whether they are
found in this country or in Europe.
Nurseries. — The report of the Sisters of Charity
Foundling Asylum, in Washington Square, for the
past year, shows a fatality of fifty-five per cent.
The Report of the Brooklyn Nursery (admitting
the same class of children), under the Homoeopathic
care of Dr. Aten and Dr. 1. Freeman Atwood,
shows a fatality during the same period, of twenty
per cent. If the Allopathic school, as some of its
members claim, is the school of science, and the
Homoeopathic that of the worst form of charlatanry
and humbug, would it not, in the light of these
statistics, be better for children, at least, to have a
little less allopathic science and a little more ho-
moeopathic humbug.
The Medical Union.
109
The Medical Union
A MONTHLY JOURNAL
Of Medicine, Surgery, and the Collateral Sciences.
Editors :
EGBERT GUERNSEY, M.D. CHARLES E. BLUMENTHAL, M.D.LL.D.
JOHN C. MINOR, M.D. ALBERT E. SUMNER, M.D.
H. M. PAINE, M.D.
Published on the First of each Month, by
C. T. HURLBURT, 898 Broadway, New York.
NEW YORK, MAY, 1873.
" A regular medical education furnishes the only presumptive
evidence of professional abilities and acquirements, and ought to be
the only acknowledged right of an individual to the exercise and
honors of his profession." Code of Medical Ethics, Amer. Med.
Ass., Art. iv, Sec. i.
OUR JOURNAL.
In every new enterprise in journalism there is
plenty of hard work, sometimes an abundance of
good wishes and cheering words, but not unfre-
quently very poor pecuniary returns. In establish-
ing the Medical Union we have had a large
amount of hard work, at which we have not com-
plained, for we commenced the enterprise only
after counting the cost and with our eyes wide open ;
and that work has been cheered by the good wishes
and cordial greetings we have received from every
part of the country, not only from the veterans in
our ranks, but from the rising generation fresh from
the schools and from winning their first laurels in
the great field of medical practice. We are con-
vinced from these numerous expressions of good
will and earnest words of encouragement, that just
such a journal as the Medical Union is needed,
and it gives us pleasure to state to our readers that
its pecuniary success is beyond our expectation.
We give a few extracts from the large number of
communications we have received from different
parts of the country :
Dr. E. M. Hale, of Chicago, writes : " Your pro-
spectus, which is before me, reflects the opinions
for which I have been striving for many years. It
appears to me this is an opportune time for such an
effort, and you have my sympathy and support.
You are taking that position in medicine that the
first minds in the world are taking in science, reli-
gion and politics."
Dr. E. C. Franklin, of St. Louis, says, " The
first No. of your Medical Union has come to
hand, and in its perusal I am more than gratified at
the dignified tone it holds, and am sure that success
will perch on your banners. Go on in your good
work and count me as one of your friends on this
side of the line in doing all I can to further the ob-
ject of your paper."
Dr. Wm. H. Watson, of Utica, writes, " Your
journal is admirable. I feel the greatest interest in
it, and will support it with the little influence I can
bring to bear, and will be most happy to contribute
to its pages."
Dr. J. N. Anderson, of Rochester, says, " I shall
do what I can to assist you. I am Secretary of our
County Society, and shall take pleasure in introduc-
ing your journal and sending you the reports of its
meetings."
Dr. T. G. Comstock, of St. Louis, writes, " I
am very glad you intend publishing the Medical
Union. I have seen the first number — its spirit
and ring suit me. I have openly advocated such
doctrines as I see published there, for twenty years
past."
Dr. C. McK. Dinsmoor, of Terre Haute, Ind.,
writes, " Through the kindness of Dr. I. Ehrman,
one of the oldest and most successful homceopathists
of the West, I have received a copy of the first
number of the Medical Union, and have read
with much interest its various articles, especially the
'Salutatory.' I am more than pleased with its
manly sentiments. Our branch of the medical pro-
fession greatly needs just such a journal as you pro-
pose to publish, and may its success be commen-
surate with the ability with which I feel assured it
will be conducted."
Dr. Denison, of Fairfield) Ct., says, " I am much
pleased with the animus of the journal, and the
object which I hope will be accomplished by it.
Though I have, in a measure, given up the practice
of medicine, (I am almost seventy years of age,) I
hope to live long enough to see a better spirit among
those whose profession it is to relieve the sufferings
of their fellow men."
Drs. Aton and Atwood, of Brooklyn, write, " The
position you take seems to us the only true position
upon which to stand. Judging from the first number of
the journal before us we predict for the enterprise the
fullest realization of your hopes, and the consequent
accession to our medical literature of a most valu-
able and progressive element."
We have quoted sufficiently from the letters which
are almost daily received from our professional
friends to show the estimation in which our enter-
prise is held by some of the leading minds and most
earnest workers in our school throughout the
country. The secular press have invariably spoken
in terms of commendation. As the organ of public
sentiment they deplored the bitter animosities which
exist between different branches of our profession,
and warmly welcomed the frank and straightfor-
ward statement of our position and principles. The
New York Times, in an editorial article of over a
1 to
The Medical Union.
column in length, discusses the question from its own
stand-point with great ability and force, in which it
takes the position that the bitter hostility shown by
one class of physicians to another when both are
equally educated, is unworthy the spirit of the age,
and of a profession which claims to be scientific.
About this position it seems to us there can be but
one sentiment among all fair-minded men. It is
needless for us to say to those who have read our
journal that with many of the statements and with
much of the reasoning of this article we do not
agree. It was written and published in the daily
round of work of an influential paper accustomed to
seize hold of and discuss questions of public interest
as they appear, without any solicitation on our part
and without our knowledge. And yet Dr. Lippe
makes this article the text of a bitter, and we are
sorry for the reputation of our profession to say, an
ungentlemanly attack upon us, and goes on to discuss
the article as expressing our sentiments, charging
us not only with having, at least, procured its pub-
lication, and ourselves as publishing the journal as
a professional advertisement ; and one of the West-
ern papers can find nothing better for its columns
than this slanderous attack, with the comment, that
it is the opinion of an old homoeopath. Now we
are upon this subject, we quote a letter from the
North American Journal of Homoeopathy, which
the editor introduces as, " from one of my most
highly esteemed friends, and a true disciple of
Hahnemann."
. Here it is with all its elegance of diction : " Your
flirtation with the MEDICAL UNION is significant;
the North American Jotimal is with them (we are
so informed). Just one more Copperhead nest
taken in, to hatch for us the very devil. Notwith-
standing your perpetual prediction of peace, there
can be none. There must be back-bone enough in
New York to fight them, and if we cannot expel
such fellows who desire to make eclectics out of the
homoeopathic school, from our societies, then we
had better strike our flag and hide our faces."
Terrible, is it not ? The very thought of being
driven from such .charming society as the writer,
and the learned professor who makes this letter a
text for one of his amiable discourses, is almost too
great a shock for our nervous system. We can
only console ourselves with the thought that we
shall probably be in very good company. All such
critics as we have quoted above we shall hereafter
leave to the tender mercies of our friend and cor-
respondent, John Crannel.
One word in reference to the name of our journal,
the Medical Union. It is hardly necessary for
us to say to those who have perused our pages, we
do not mean by it any giving up of great principles,
for such a union would be a rope of sand, falling to
atoms with the slightest strain. We mean a fair,
clear and distinct enunciation of our principles,
without evasion, without concealment, and without
one grain of reservation, and an open manly dis-
cussion of them. We believe that half the dissen-
sions in religion, in metaphysics, in medicine grow
out of misunderstanding of terms, and in attribut-
ing to others motives and views which they do not
possess, and that many of the differences could
easily be harmonized with a little more social feel-
ing, without any loss of self-respect or giving up of
principle. In taking this open, manly position we
have done our duty. We have no favors to ask,
and while we shall at no time hesitate to express
our earnest convictions, and contend with all our
strength for their supremacy, we shall never sacrifice
principle to expediency. In the Medical Union
we have a work to perform above petty spites and
the wrangling of cliques. We shall contend earn-
estly for the great principles of our school, for the
elevation of the standard of medical education, and
for the broadening and deepening of the great stream
of medical science. We. ask the co-operation of our
friends everywhere. The work is yours as well as
ours. Let us all work for the highest interests of our
profession, and thereby for the good of Humanity.
AMERICAN INSTITUTE OF HOMEOPATHY.
The oldest medical association in the United States
will hold its twenty-sixth session on its thirtieth
anniversary, at Cleveland, on the third of June.
We remember distinctly its session in 1848 in the
old Society Library building on the corner of Leonard
Street and Broadway. Fresh from the allopathic
school, we had never met an assemblage of more
earnest men, and certainly had never heard great
medical principles more clearly and ably discussed.
There was, too, a unity of purpose and action, a
standing together shoulder to shoulder, in the ranks
of a great reform, a determination to win success
for the principles which seemed so grand to them,
in their beauty and simplicity, by united effort and
patient, intelligent labor. But little more than a
quarter of a century has elapsed since then, and
the little band has grown into a mighty host,
scattered from ocean to ocean, and everywhere
doing good and noble work for suffering humanity.
This association, meeting year after year in different
locations, has done much to help on the good cause,
not only in gathering together the practical ex-
perience of physicians from every part of the country,
but in keeping up a social feeling and a hearty sym-
pathy with each other in the great work in which \
they were engaged. The old illustration of the
bundle of sticks is still as forcible as ever. In
union we have found strength, and, fast anchored to
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i j i
great principles, we have not been afraid of the
materialistic tendencies of some, or that transendental
philosophy of others, which is most at home in the
misty realms of dream-land, convinced as we have
been that while all were thoroughly imbued with the
great principles of our school, no permanent danger
could arise from a tolerably wide latitude of investi-
gation.
Much as has already been accomplished by the
American Institute of Homoeopathy, there is open
before it a still broader field of usefulness, and we
are glad to see from the circular of the General
Secretary, Dr. McClatchey, tnat the papers which
will be presented at the meeting in Cleveland, will
treat on important topics, and be of more than usual
interest. In a deliberative body like this, made up
of delegates and members from every part of the
the country, the best thoughts should be presented,
not in a crude state, but well digested and well pre-
pared. In this way something of real value may be
given to the public, and we shall command the re-
spect of the scientific world as earnest workers in that
great field of scientific research which is every day
broadening before us.
Much of the usefulness of the institute depends
upon its presiding officer and the members of the
different bureaus. Men should be selected who
have the ability aud energy to marshal its forces,
and draw out its immense resources. There is no
reason why, in the extent and varied character of
the information presented, the deliberations of the
American Institute of Homoeopathy should not equal
those of any scientific body in the world ; but this
can only be done where the majority of its mem-
bers realize that this is a deliberative body, assem-
bled not to listen to childish talk, and stale puns
and jokes, but for the discussion of great questions
of vital interest to the welfare of humanity.
MEDICAL LEGISLATION.
Some of the members of the State Medical Soci-
ety are extremely anxious to regulate the rest of
mankind, and for that purpose have introduced a
bill at Albany. The bill is substantially the same
as that introduced last year and passed both houses,
and was vetoed by the Governor. Dr. Rogers of
this city is the father of it, and it was amended by
Dr. John F. Gray and endorsed by the State Socie-
ties. It provides for the appointment of five censors
by each County Society of either school, who are
thereby empowered to enforce the requirements of
the bill. In case a homoeopathic physician should
reside in a county where there is no County Society,
he may go before the censors of any County Society
in the State and obtain a license. It does not dis-
criminate invidiously in favor of the practitioners of
either school, but gives the same powers and im-
poses the same duties on all alike. In this respect
it is different from the bill recently introduced in the
Pennsylvania legislature, which gives to the old
school the power to regulate the others. This bill
has been ably criticised by the editors of the Medi-
cal and Surgical Reporter (Allopathic). A similar
bill was also passed by the legislature of North
Carolina a few years since. The Reporter says of
the Board appointed under this Act, "They are all
regular physicians, of course, and it seems to us they
must find themselves in an awkward position when
some well-educated and respected homoeopathic phy-
sician appears before them. If they grant him the
right to practice, they are directly countenancing and
aiding what, in their hearts, they believe a false and
dangerous charlatanry. But they cannot follow out
the dictates of their own intellects and consciences
and summarily put a stop to his labors. Their posi-
tion is the last one to be envied." Undoubtedly
this feeling exists in the minds of many intelligent
members of the school to which the Reporter be-
longs ; but it is in the power of a few ignoramuses
to bring the whole school into disgrace and con-
tempt. We confess to have an objection to being
"regulated" by a society to which we do not be-
long; and we presume the same feeling exists in
the minds of some of our brethren in Pennsylvania
and North Carolina. As a general thing, we be-
lieve that each physician would be more comfort-
able and useful if he was allowed to "regulate"
himself.
Ihe JFledical Union Clinic.
CLINICAL LARYNGOSCOPY.
Sub-actite Laryngitis and bi-lateral Paralysis of
the adductors of 'the vocal 'chords. — Josephine L., aet.
1 6, applied for relief at the Brooklyn Homoeopathic
Dispensary, January 29th, 1873. She had taken a
severe " cold " Christmas week, and since that time
had completely lost her voice. Inspection of the
fauces revealed general congestion, and right tonsil
enormously hypertrophied. This was removed at
the first sitting. Larynx larger ; mucus membrane
much congested, and slightly thickened. Epiglottis
erect, and somewhat congested upon its posterior
face. Vocal chords, which are thickened and
bright red in color, fail to move toward the median
line, during phonotion, but remain widely dis-
tended. A gargle of Flor Chamomilla was pre-
scribed as an application to the surface of the ex-
cised tonsil.
February 28. — Patient has been under treatment
(principally local) for the past month ; during that
time the excised tonsil healed kindly, under stimu-
lating and astringent inhalations, often repeated ; the
paralysis is removed, and the voice almost com-
pletely restored, although some congestion yet
remains.
March 5. — Is much worse from a renewed cold.
Can with difficulty speak above a whisper. Vocal
112
The Medical Union.
chords fail to meet posteriorally. Bowels very con-
stipated. Prescribed Nux Vom. 3d, and inhalation of
Ferri per-chloridi.
March 12. — Much improved. Caust. 6. This
treatment was continued until March 28, with con-
stant improvement of all the symptoms.
March 29. — Voice but a trifle rough in sound.
Vocal chords free from congestion or thickening.
No treatment from this date to April 16, when the
patient again presented herself. During the in-
terval she has steadily improved, and at this time
found the voice clear and natural, and all traces of
inflammation gone. Discharged.
E. J. Whitney, M. D.
Fibrous Polypus of the Uterus re?noved by Elastic
Ligature. — This case was simply an ordinary one
of polypus uteri. Repeated haemorrhages from the
uterus led the patient to submit to an examination
which revealed the presence of a small pediculated
polypus on the posterior wall of the uterine cavity.
Instead of using torsion or the ordinary ligature, I
determined to try the effects of elastic constriction.
After an infinite deal of trouble I managed to pass a
double elastic cord of india rubber around the neck
of the polypus I passed the projecting ends of the
cord through a canula (formed by cutting off the
end of a gum catheter,) which was then pushed up
against the neck of the polypus. Then the con-
stricting cord was drawn moderately tight and
fastened. Every day the elastic ligature was tight-
ened a little, and on the sixth day the polypus
dropped off. There was no bleeding nor any evi-
dence of local irritation or constitutional disturbance.
The polypus was about the size of a pigeon's egg,
with a pedicle a third of an inch in diameter. I
have used this form of ligature with excellent results
for the radical cure of varicocele and varicose veins
of the legs. John C. Minor, M. D.
Beuiews of Boohs.
American Medical Education. Annual ad-
dress before the State Medical Society, by John F.
Gray, M. D., LL.D.
After referring to the provisions of an act pre-
pared by himself, and which has recently become
a law, to elevate the standard of medical education,
Dr. Gray states the deficiencies of the present
system in the following terse and vigorous language :
" We all, of both schools, alike deplore the absence
of preliminary requirements of an educational char-
acter in all our American laws regulating the license
to practice medicine and also in each of the charters
regulating the colleges of medicine. No culture in
any science nor in any literature whatsoever, not
even a primary school training in our vernacular
English, is demanded of the pupil on his applying
for admission to any one of our numerous medical
colleges. Nor, when he approaches the censors of
any State or county medical society for his license,
or the faculty of any college for the doctorate, is he
required to exhibit any knowledge of the learned
language in which all his future prescriptions for
the cure of the sick and the relief of the dying are
expected to be written by his own hand.
" Thus, by implied consent of every one of our
State governments, the medical pupil is allowed to
enter upon and complete a three years' course of
reading, lectures and demonstrations, in every line
and fact of which he must encounter technical
phrases drawn from Latin and Greek sources, each
one of which proves a stumbling-block of detention
to him or a cheering aid, as he may be instructed
in or ignorant of those languages. If, by sad
chance, he know nothing of these two keys to the
rudiments of scientific medicine, he must not only
go through his college Courses, but also through his
entire life career, be his natural gifts what they may,
in a lame, confused and ever incomplete apprecia-
tion of all that he reads in books, or hears from
learned teachers, and, consequently, of all that he
himself observes also. Wonderful tact, ever tend-
ing to debasing artifices, does it require of a practi-
tioner so situated in society, to support the implied
role of a learned citizen and accomplished phy-
sician ?
" The profession and the government are both in
fault, alike responsible for this sad state of medical
education. It is lack of energetic statement on our
part, and of generous co-operation for its removal ;
and on the part of the government it is a culpable
unwillingness to interfere with the fancied rights of
incorporated medical schools.
"The government permits any man over twenty-
one years of age to canvass for the degree and
license, without challenge as to any other depart-
ment of knowledge than medicine, and of that only
the sketches and summary contents of two hurried
courses of lectures delivered by teachers of whose
attainments it can have no test or scrutiny what-
ever, beyond the degree obtained from other
teachers of the same order of education. Moreover,
the government takes the testimony of these
teachers, so appointed, as to the qualifications of
candidates for the degree and license, when it
ought to know that their pecuniary interests urge
them to push illiterate and otherwise unfurnished
young men into a profession full to its brim with
weighty responsibilities and imperiled duties. The
profession should protest, but it does not ; and so
its overcrowded ranks go on receiving accessions,
by thousands annually, of doc tores indocti, nay,
even indoctissimi, from generation to generation.
This sad and ever-growing evil cannot continue
very much longer; an enlightened community
must, ere long, demand higher courts of examin-
ation than the colleges furnish, stronger preliminary
training than common country schools can give,
and an impartial and watchful supervision of the
license to practice our sacred art by a high com-
mission in each State.
"When that day arrives, and when this great
State shall have charged the regents of its uni-
versity to institute a uniform test of merit above the
present college diploma and the county and State
society license ; when, in short, the government
shall have instituted a State examination of all
aspirants for practice, within its limits, like the
German Staats examen, the profession will begin
(but never till then) an ascending scale of acquire-
ment and of efficiency in the bestowal of its great
benefits.
"When our country was younger and all the
States were sparsely populated by widely separated
nuclei of settlements, with slow and difficult chan-
nels of intercourse between them, our American
system of licensing unlettered men as practitioners,
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113
who might, however, happen to know a few maxims
of surgery and medicine, was admissible, as being
the best that could be accomplished. This was
better than no scrutiny and no license at all, im-
perfect and unsafe as it certainly was ; besides, by
being early placed under the surveillance of the
county judiciary, it was a rudimental framework for
a nobler future reality."
After mentioning several of the studies in which
the student of medicine should be thoroughly con-
versant, he dwells at length upon the importance
of a careful study of the science of physiology.
" It is not as generally understood as it should be
that this science is of the fullest importance to the
homceopathist in the choice of his remedies. Hahne-
mann's definition of disease is, that it is, in every in-
stance, a change of vital activity ; not a quantitative
mutation in the substance or entity of life, but a new
series of reaction to morbific influences, whether phy-
sical or psychical. Disease, as the object of our art, is
simply and only a change of functional phenomena.
It is not an imported substance, an outside entity.
It is only the life of the subject, manifesting it-
self under certain conditions by changed sensations,
changed functions, and, lastly, by changed growths
or products. The latter are not the homceopathists'
objective, but their efficient cause is ever his art-
point of attack. Wherefore, as the whole assem-
blage of such sensational and functional changes and
their structural results, in every medicable sense, is
the only attainable conception of the disease, i. e.,
of the state to be removed, and also is the only sci-
entific clue by which a remedial agent can be
reached, homoeopathy forbids her disciples to deviate
from the pathways of sound evidence, the domain of
every positive science, by a transcendental search
for his art-object among the illusory conceits and
evermore changing hypotheses of the elder methods.
"Entity is objective to God alone ; no finite intelli-
gence can know anything of it except its utterings,
its phenomena : no quantitative or qualitative
changes in life itself have ever been, or ever can be-
come, appreciable by human observation.
" But how can we, of this stringent method of pro-
cedure, appreciate disease otherwise than by study-
ing well, sharply, incessantly the vital activities and
the functional utterances of the healthy organism-
otherwise than by amply knowing physiology ?
" Allopathy makes use of physiology chiefly — per-
haps I may say exclusively — to aid her disciple in
his impossible endeavor to know the nature — not the
phenomena only, but the nature of — disease. That
is to say, allopathy seeks to know and evermore
affects to understand what that change may be in
the inscrutable entity, life, which produces the
symptoms of the sufferer.
" Homoeopathy makes use of physiology to guide
her disciple in the detection of his art objective, the
grouping out of the totality of morbid symptoms
and morbid products in each case ; and she forbids
him to attempt to found a scheme of cure, in any
possible instance or emergency, upon assumptions
drawn from that realm of conjecture which lies out-
side the well defined limits of human observation,
of positive silence.
"The allopathist, moreover, assumes to be aware,
in some a priori way, impossible in any human
science, that some drugs diminish or increase life
quantitatively, and that others affect it qualitatively ;
and he chooses his remedies, against .his assumed
biological morbid changes, from these his fancies
about drug powers. Hence his nomenclature of
tonics and debilitants, and of narcotics, sedatives,
deobstruents, etc. ; and hence his compounding,
combining and classifying of mixtures which cor-
respond to his fancied "indications of cure." His
physiology, too, must bow to his a priori ten-
dencies, and the functions in health and in disease,
must, in his method of art, depend on correlated as-
sumptions about life as to quantity and tempera-
ment.
" But the homceopathist assumes nothing whatever
a priori as to drug powers. He tests these by care-
ful trials of them, each one by itself, and he knows
them only through their purely physiological
effects ; and his interpretation of such effects is not
vitiated by assumptions in the unsettled departments
of physiology. He cannot classify his remedies ;
each drug, after its proving on the healthy, is the
symbol for totality of its own physiological effects
alone.
" The homceopathist must, moreover, know physi-
ology thoroughly, in order to conduct drug trials, on
himself or others, with precision and success, for the
enriching of the materia medica.
" Without physiology he cannot take a single sure
step in the onward progress of this vital branch of
his school; nor can he administer, in a scientific or
self-satisfying manner, any of its resources for the
healing of diseases.
" Long centuries ago, Galen, one of the immortals
of our profession, saw, in a moment of profound in-
spiration, the true use of physiology in practical
medicine ; although he utterly failed to apply it in
his art precepts in the only way which the obvious
truth of his great maxim demands.
I have great pleasure in calling his golden words
up from the buried past, as, in my judgment, the
most fitting expression of the right side of our great
controversy regarding the primordial elements of
the art of healing which can be found in the whole
literature of medicine :
' ' ' Cujusque morbi tanta est magnitudo, quantum
a naturali statu recedit ; quantum vero recedat, is
solus novit qui naturalem habitum \physiologiam\
ad amussim tenueritJ'
"My dear junior colleagues, renew and steadfastly
persevere in your pursuits of this great science.
With the aids of your scalpel, a chemical laboratory
and the microscope, make practical researches in
verification of each important department in physi-
ology. For thus and only thus can you righteously
discharge the obligations of a practitioner, or the
functions of a teacher of scientific medicine. Learn
from physiology and chemistry, patiently studied,
how to estimate with justice and candor the great
issue, joined over sixty years ago, between the two
schools in medicine. Find from this culture the
real value of Hahnemann's protest against the
transcendental methods in the elder, and also the real
value of his contributions to the later of these
schools. Study his Organon of Rational Medicine,
and also Grauvogl's Co?nmentaries, with faithful at-
tention.
" Learn to appreciate the strength of your position ;
to know that it is impregnable, however few its de-
fenders, because its foundations are laid in ascer-
tained science and imperishable philosophy. So
shall you be able to bear arms worthily in the un-
welcome contest to which you must be a party, and
U4
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to await its termination with tranquil assurance. For
terminate it certainly will, and that in peace honor-
able to you and grateful to the other party. I trust
the day of reconstruction is not very distant.
" The history of civilization shows a steady progress
in the toleration of differences of opinion in politics
and religion. The ratio of that advance in tolera-
tion is manifestly a progressive ratio, so that the
philanthropic observer can feel its movement to be
at the rate of at least ten ages for one, as compared
with that of the epoch of the last religious wars of
Europe.
" To-day Roman Catholics and Protestants live in
political amity, and even social good-will, who, less
than three hundred years ago, were reciprocally
lighting the torch and wielding the rack for enforc-
ing uniformity of opinion : and most of this grand
achievement has been attained within the last half
century ; nay, as to masses of population, within the
last ten years.
" The documents of toleration gather upon us day
by day • thicker than leaves in Vallambrosa ; ' for
modern civilization, understanding the rights of
man and knowing the necessity of liberty for their
support, is walking away in supreme contempt from
the apparatus of enforced uniformity.
" Stand firmly in your place, my young friend ; as-
sert your right with that of every other man to utter
and to follow the opinions which fact and reflec-
tion honestly produce. Be thou of the party of
toleration, for that is the party of justice, of true
humanity !"
We need offer no apology to our readers for the
lengthy quotations we have made from this very able
address. It is seldom that medical questions are
handled with the clearness, the strength, and classic
force and purity of expression which characterize
this paper. The closing sentiments are so directly
in accordance with the spirit and teachings of the
Medical Union that we quote them with peculiar
gratification.
A Practical Guide for Making Post-Mortem
Examinations and for the Study of
Morbid Anatomy, etc., etc. By A. R.
Thomas, M. D. Boericke & Tafel.
The Hahnemann Medical College of Philadelphia
is fortunate in having a faculty who have fairly
earned the reputation* of placing their institution
foremost among the homoeopathic medical schools.
This honorable position has been acquired not by
persistent advertising, nor by claiming the possession
of remarkable educational facilities, but by the in-
dividual worth and ability of the professors. While
we would not lessen the merit of the rest of
the faculty, we must regard a very large pro-
portion of this success as due to the rare attainments
and thorough teaching of Professor Thomas in the
department of Anatomy. The book before us is
from the pen of this indefatigable worker, and is a
good illustration of his method of instruction. The
title of the book gives a clear idea of its contents.
It is a practical guide for making post-mortem ex-
aminations and for the study of morbid anatomy,
and is, beyond comparison, the best work of its
kind. In fact it is the only work of its kind, inas-
much as it is the only one that practically meets the
requirements of physicians in ordinary practice.
The larger work of Delafield, and the unwieldy
volumes of the French and German pathologists
are valuable as works of reference ; are absolutely
necessary indeed, for thorough research into the
nature of morbid conditions. But the book before
us is one of ready reference, giving clear directions
as to the best methods of performing post-mortems
and concise but comprehensive instructions for the
discovery and recognition of morbid phenomena —
just such a work as those who make but few post-
mortem examinations will find of most assistance.
One feature of the work we cannot recommend too
highly — the rejection of many of the cumbersome
subdivisions of diseases and the adoption of the
simplest forms of pathological nomenclature. It is
refreshing, after wading through the eight or nine
varieties of Bright's Disease given by Rokitansky,
to come down to the three recommended by Thomas.
This conciseness is not reached at the expense of
accuracy, for the author is very exact in his defini-
tions, and is thoroughly reliable so far as he goes.
And here he shows a rare judgment in not carrying
his subjects too far. For instance, in treating of the
degenerations of the liver, Professor Thomas thus
describes the waxy or lardacious disease: " In this
form of disease, the liver undergoes greater enlarge-
ment than in any other disease excepting cancer.
The enlargement is uniform in every direction, so
that the form of the gland is unchanged. Pain and
tenderness are never prominent symptoms of this
disease, hence the liver may be manipulated during
life with impunity, the patient complaining only of
weight and tightness in the right hypochondrium.
"The progress of the disease is usually slow, ex-
tending in most cases over several years. The
spleen, kidneys and intestines will frequently be
found presenting this change at the same time.
"The tissue of the gland in these cases is very firm,
so that the organ generally retains its form when
laid with its convex surface on the table. The ex-
ternal surface is smooth and free from adhesions.
When cut, a peculiar translucent substance is found
infiltrated through the tissues, giving it a firm,
glistening appearance, known as waxy, lardacious,
amaloyd, albuminous, or sometimes scrofulous liver.
This substance is stained a deep red by the action of
a weak solution of iodine.
"The change appears to commence first in the
small blood vessels, finally extending to the lobules,
appearing first in the centre, and ultimately involv-
ing the whole lobule.
" The disease is more common in males than
females, and is frequently caused by constitutional
syphilis. In some instances, it would appear to be
produced by a tubercular diathesis, and co-exists
with some local form of scrofulous disease, or by a
long exposure to malarial influences."
This is a fair sample of the descriptions given by
Professor Thomas of the various pathological con-
ditions, and we quote it to show of what material
the whole is made. In glancing over the de-
scription we are favorably impressed, not only by
what the author says about the waxy liver, but also
(to use a Hibernian expression) by what he does not
say. It would doubtless be interesting to a few if
Professor Thomas had gone into the subject more
at length, giving a full history of the lardacious dis-
ease, as a general affection of the blood having local
habitudes, as shown by Drs. Gairdner and Sanders,
but more especially by Meckel, who calls it the
" cholesterine disease," and supports his views with
a vast array of chemical and microscopic demon-
The Medical Union.
US
strations. The researches of Budd into the scrofu-
lous nature of the disease; the opinions of Oppolzer,
who calls it a "colloid liver," or of Engel, who con-
siders it a true hypertrophy, all these additions and
extensions might please a few, but the practical
character of the book would then be lost to the
many. Professor Thomas very wisely leaves the
deeper points of pathology untouched, and confines
himself to meeting the wants of the physician who
wishes to clear up a difficult case of diagnosis by a
post-mortem examination. For this purpose the
book is thoroughly good, and, because the author
has refrained from pushing the examination into the
vexed ground of pathological histology, it will
always be a standard work. In reviewing the book
as an introduction to the study of morbid anatomy
we can only add to the praises we have already
bestowed upon it. It is not likely that in this
country there will ever be the same facilities for the
study of morbid anatomy that exists in Europe, and
particularly in Vienna. Nevertheless there is no
excuse for banishing it entirely from the curriculum,
since the material for instruction is sufficient, pro-
vided the study is systematized. A post-mortem
examination should be made of every subject in the
dissecting-room, and, with the book of our author
as the text for every student, we will venture the
opinion that one winter's course so conducted would
be of more practical benefit to the future physicians
than all they learn at present in pathology and topo-
graphical anatomy during a full course of two or
three years. Used in this way the work of Professor
Thomas would be of great value as a text-book for
students during their first course in pathology, to be
replaced, as they advance in the science, by works
of wider scope and more exhaustive nature.
J. C. M.
The Characteristics of New Remedies. By
Edwin M. Hale, M. D.
Every homoeopathic physician who possesses and
has read the first and second edition of the New
Remedies, must have conceded that the author's
service to the cause and advancement of our school
is only second in rank to that of Jahn, when he gave
us the Codex and Repertory : The labor and research
bestowed upon such a work can only be appreciated
by men who have engaged in similar undertakings.
The treasures bestowed upon the profession in
these volumes, many of which lay scattered in every
direction, had to be culled with great care, and the
dross separated from the pure and valuable mate-
rial. All these labors the author seems to have per-
formed with a zeal and indefatigable perseverance
which show that it was a work of love, which can
have its best reward only in the consciousness of the
service which he has done to the profession.
The third edition, with the title of Characteristics,
is now before us, and improved in many respects ;
though, to those who do not possess the first or sec-
ond edition, the omission of the description of the
respective plants will be a disappointment. The
author does not tell us what the due considerations
were which led him to omit so important a part to
the practitioner, but he has given us instead a
valuable addition of eighty new medicines ; but we
regret that these also, though never furnished by
him before, with a description, are also given with-
out this very important article. But we gratefully
accept, nevertheless, the valuable services he has
rendered to the profession, in giving us the complete
characteristics of nearly all the new remedies which
modern research and provings have furnished to the
healing art.
We need hardly add that no physician, who de-
sires to give his patients the benefit of all the new
discoveries and remedial agents, will, or can, do with-
out the book. It will lighten the labors of every
homoeopathic pyhsician who consults its pages
daily before he decides upon the proper remedy
for the diseases he is called upon to combat.
The New York Journal of Homceopathy,
under the auspices of the New York Homoeo-
pathic Medical College. Wm. Tod Helmuth,
M. D., and T. F. Allen, M. D., Editorial
Committee. Carle & Grener, Publishers.
$3 Annual Subscription.
This new addition to the ranks of the homoeopathic
monthlies has now issued three numbers, and will
compare favorably with some of the older journals.
Its editors are well known as able men, and the
articles already contributed show a laudable desire
on the part of both editors and contributors to make
the Journal one of practical value. The general
tone of the journal shows a decided tendency toward
the advocacy of the high potencies, and this feature
will commend it to many who are convinced of the
efficacy of infinitesimals. Being under the auspices
of the New York Homoeopathic Medical College,
the Journal will probably reflect in its pages the
general ability and scholarship that already charac-
terize the faculty of that college, and we shall look
with pleasant anticipations for the contributions of
the several professors. We hope the new journal
will meet with a deserved success, and that the col-
lege will become more prosperous and efficient than
ever before.
The Cincinnati Medical Advance. T. P. Wil-
son, M. D., Editor. Published by Everett W.
FlSH, M. D., Cincinnati, Ohio. $3 a year.
This new journal seeks to occupy new grounds.
"We shall stand upon a point midway between a
strictly medical and scientific journal," says the
editor. We have no doubt that the field is a good
one to occupy, and that Dr. Wilson is able to take
possession. We have a kindly leaning towards new
journals, and especially towards those that display
the liberality and broad views expressed in the first
number of the Advance. We see much to praise in
it and believe that whatever imperfections exist in
the first number are due to the difficulty of locating
that midway point. The practical articles are all
excellent, and Dr. Wilson's contributions will well
repay the attention of the profession. We wish our
friends a good success and extend to them our
cordial greeting.
Dr. Tullio S. Verdi, of the Board of Health of
the District of Columbia, has been selected by the
Governor to visit Europe to examine into sanitary
regulations abroad. The Secretary of State has
furnished Dr. Verdi with a circular letter to the
Ministers and Consuls of the United States in
Europe, to aid him in his mission. No better se-
lection could have been made, and we shall look
for an interesting and valuable report from Dr.
Verdi on his return.
n6
The Medical Union.
Scientific ifileanings,
Retention of Urine; Puncture with Ca-
pillary Trocar — Dr. Clewzean mentions a case
where in a case of hypertrophy of the prostate gland,
no urine was discharged from the bladder except by
overflow. Catheterism having failed, Dr. C. punc-
tured the bladder above the pubis with the needle,
No. I, of Dieulafoy's aspirator. This was repeated
six times in four days; then he succeeded in passing
through the urethra an olivary bougie, and soon
after the patient learned to introduce it himself.
Skin Grafting. — Dr. Griffin i of Pavia says
cutaneous grafting is indicated in all wounds in full
and uniform granulations when we wish to ac-
celerate healing. In chronic wounds of old, or
cachectic persons ; in varicose ulcers, with callous
margins. In those cases of extensive wounds where
spontaneous cicatrization would be attended with
considerable retraction of the parts ; burns ; in
wounds of hard surfaces covered with skin only, as
the front of the tibia.
A Cure for Diabetes Mellitus. — Professors
Cantani and Primavera of Naples report the most
extraordinary success in their treatment of this
obstinate disease. The cure consists in an exclu-
sive meat diet, and by this term fish is also in-
cluded ; further, at each meal is to be taken Lactic
acid, two to four scruples in six ounces of water.
As a substitute for wine at dinner, half an ounce of
alcohol with six ounces of water is given. Alcohol
and Lactic acid are designed to replace the sac-
charine and starchy elements of the food. To
obtain a permanent cure it is necessary to persist in
the treatment for several months after sugar has
ceased in the urine. Then the patient may
gradually return to a mixed diet.
— Allgemein. Med. Central. Zeitung, 1873.
On the Use of Iodoform in some Venereal
Affections. — By Dr. Izard, of Paris. — Dr. Izard
has employed iodoform in the treatment of infect-
ing chancre and of some secondary and tertiary
symptoms of syphilis, of soft chancre and consecu-
tive bubo, of phagedenic chancre and of mixed
chancre. He claims for this substance only a local
action, and he thinks it has but little influence on
the indurated chancre, except in certain conditions
of that form of sore. In syphilitic inflammation,
iodoform is very usefully employed either as a po-
made, or in a solution of alcohol and ether. If the
gland suppurates in scrofulous or lymphatic sub-
jects, and if a number of openings are formed, the
iodoform will cause them to heal. Ulcerated forms
of syphilitic d's'ease, rupia and gummata have
yielded rapidly to the employment of iodoform, but
with the addition of internal constitutional treat-
ment. When the soft chancre is very painful, the
anaesthetic properties of iodoform .render its em-
ployment advisable. In simple bubo, a pomade of
iodoform, applied for a few days, has sometimes
caused the absorption and disappearance of the
swelling. In the chancrous bubo, iodoform is not
equally efficacious in the different stages of inflam-
mation, suppuration and ulceration. In the first
stage, if the swelling is painful, the iodoform po-
made will be useful ; in the second it is useless ; in
the third, after the purulent matter is evacuated
and there still remain openings in the sore, repeated
injections of iodoform will cause the ulcerated open-
ings to close. Phagedenic sores, when once their
true nature is revealed, are not benefited by iodo-
form, but the mixed chancre may be advan-
tageously treated by this agent. A case is recorded, I
in which the action of iodoform was beneficially
exerted in a case of venereal disease ; and Dr. Izard
declares of this new therapeutical application, that
venereal sores so treated, are cicatrized ten, fifteen
or twenty days sooner than when other methods are
employed. — Bulletin General de Therapeutique.
The Nutrition of the Lung-tissue in Con-
sumption.— Dr. W. Marat, F. R. S., has con-
tributed a valuable paper on this subject to the
Philosophical Magazine. Among a great number
of conclusions, the following bear especially on the
point above stated: (a) That in phthisis a given
weight of muscular tissue contains less nutritive
material than it does in health, less mature or in-
soluble tissue, rather more water and a much higher
proportion of chlorine and soda, (b) That in
phthisis, the phosphoric acid and potash, effete in
muscular tissue, are present exactly in the right
proportion for the formation of a pyrophosphate,
as occurred in healthy flesh. This shows that the
process of waste of muscles in phthisis takes place
precisely as it did while in a state of health, and
confirms the result, relative to the composition of
the effete material of muscular tissue ; eight analyses
of flesh yielding phosphoric acid and potash effete,
in the proportion of pyrophosphate, (c) That the
emaciation in phthisis appears due mainly to the
blood not being in the proper condition to supply
nutritive material to muscular tissue. The damp
or wet state peculiar to muscles after death from
phthisis, appears to show that the colloid state of
the flesh in that disease is somewhat deficient, (d)
That the tubercular or adenoid formation in pul-
monary tissue actually undergoes nutrition, and is
consequently a growth, the phosphoric acid and
potash being apparently eliminated as in the case
of flesh, under the form of a crystalloid phosphate.
The nutrition of the abnormal growth accounts for
the absence of any smell of decomposition, which is
nearly invariably observed at the post mortem ex-
amination, when performed shortly after death from
consumption, (e) The process of softening of the
tubercular substance appears due to a loss of colloid
power. It can hardly be owing to an increase in
the proportion of water, as there is but very little
more water in softening tubercular lungs than in
those that are healthy.
— London Pop. Science Review, April, ,J2>'
Croup — .Morbid Anatomy of. — Two distinct dis-
eases are confounded under the name of croup.
1 . Acute catarrhal laryngitis, in which there is noth-
ing more than congestion and swelling of the
mucous membrane of the larynx, with mucous
or puriform exudation on the surface. 2. Diph-
theritic croup, attended with the formation of a false
membrane independently of the age of the patient
or the severity of the inflammation, but simply
on account of the specific character of the disease
Local Treatment by Lactic Acid. — Lactic acid is
a solvent of fibrinous exudations, such as that of
croup. This property may be made of use in the
treatment of that disease. The patient must be Jk
made to inhale a solution of lactic acid (fifteen to ^
twenty drops in half an ounce of water) in the form
of spray, at first every half hour, and afterwards
when the respiration improves less frequently.
The Medical Union.
117
DIAGNOSTIC CHARACTERS OF THE CHANCROID AND CHANCRE.
Collated By Clarence E. Beebe, M. D.
THE CHANCRE.
Origin.
I. Always derived from a chancre or syphilitic
lesion.
II. Has a period of incubation.
Anatomical Characters.
I. Generally single. Multiple, if at all, from the
first; rarely, if ever, by successive inoculations.
II.- Frequently a superficial erosion; not involving
the whole thickness of the skin or mucus
membrane ; of a red color, and nearly on a
level with the surrounding surface ; sometimes
an ulcer when its
III. Edges are sloping, hard, often elevated and ad-
here closely to subjacent tissues.
IV. Surface hollowed or scooped out, smooth, some-
times grayish at center.
V. Induration firm, cartilaginous, circumscribed,
movable upon tissues underneath. Sometimes
resembles a layer of parchment lining the sore.
Generally persistent for a long period.
Pathological Tendencies.
I. Secretion scanty, chiefly serous ; inoculable
with great difficulty, if at all, upon the patient or
upon any person under the syphilitic diathesis.
II. Less indolent than the chancroid. Phage-
dena rarely supervenes, and is generally limited.
III. One attack affords complete or partial protection
against a second.
Characteristic Gland Affection.
I. All the superficial inguinal ganglia on one or
both sides enlarged and indurated, distinct
from each other, freely moveable, painless, and
rarely suppurate. Pus never inoculable.
Prognosis.
I. A constitutional affection. Secondary symp-
toms, unless prevented or retarded by treat-
ment, declare themselves in about six weeks
from the appearance of the sore, and very rarely
delay longer than three months.
The following table exhibits the usual period of development, following the appearance of the chancre,
of the more important syphilitic symptoms. — M. Martin, (Bumstead).
THE CHANCROID.
Origin.
I. Always derived from a chancroid or virulent
bubo.
II. Has no period of incubation.
Anatomical Characters.
/. Generally multifile, either from the first or by
successive inoculation.
II. An excavated ulcer perforating the whole
thickness of the skin or mucus membrane.
III. Edges abrupt and well defined, as if cut with a
punch, not adhering closely to subjacent tissues.
IV. Surface flat, but uneven, " worm-eaten," wholly
covered with grayish secretion.
V. No induration of base unless caused by caustic
or other irritant, or by simple inflammation ;
in which case the engorgement is not circttm-
scribed, shades off into surrounding tissues, and
is of temporary duration.
Pathological Tendencies.
/. Secretion copious and purulent. Anti-inocula-
ble.
II. Slow in healing. Often spreads and takes on
phagedenic action.
III. May affect the same person an indefinite num-
ber of times.
Characteristic Gland Affection.
/. Ganglionic reactions absent in the majority of
cases. When present, one gland acutely in-
flamed, and generally suppurates. Pus often
inoculable producing a chancroid.
Prognosis.
/. Always a local affection, and cannot infect the
system. "Specific treatment by mercury and
iodi7ie always useless, and in most cases in-
jurious.
SYMPTOMS.
Date of usual Development. Date of earliest Development. Date of latest Development
Roseola, -
Papular eruption, -
Mucous patches,
Secondary affections of the fauces,
Vesicular eruption,
Pustular "
Rupia, -
Iritis, - -
Syphilitis sarcocele,
Periostitis, -
Tubercular eruption,
Scorpigenius "
Gummy tumors,
Onychia, -
True exostosis, -
Ostitis, changes in the bones and cartilages,
Perforation or destruction of the velum palati,
45 th day.
65 th day.
70th day.
70th day.
90th day.
80th day.
2 years.
6th month.
1 2th month.
6th month.
3 to 5 years.
3 to 5 years.
4 to 6 years.
4 to 6 years.
4 to 6 years.
3 to 4 years.
3 to 4 years.
25 th day.
28th day.
30th day.
50th day.
55 th day.
45 th day.
7th month.
60th day.
6th month.
4th month.
3 years.
3 years.
4 years.
3 years.
2 years.
2 years.
2 years.
1 2th month.
1 2th month.
1 8th month.
1 8th month.
6th month.
4 years.
4 years.
13th month.
34th month.
2 years.
20 years.
20 years.
15 years.
22 years.
20 years.
41 years.
20 years.
n8
The Medical Union.
iCorrespcmbence*
The following interesting description of the
Glasgow Maternatie is furnished by a lady who was
for some time the Assistant Matron of the institu-
tion :
The Maternatie embraces a lying-in asylum, and
a school for nurses. Formerly there was a child's
hospital connected with it, but that was given up.
It is managed by a board of laymen and physicians,
and is entirely self-supporting. There is a matron
at the head of the establishment, and she appoints
an assistant matron. The servants are only two —
a cook and assistant cook. The washing and iron-
ing is done by the patients, and a neat, trim, little
woman is selected for a door waiter. The rooms
are small, and only three beds are allowed to a
room. Once a week the floors are scrubbed and the
rooms fumigated. The fumigation consists in evap-
orating a solution of Carbolic Acid in the closed
wards, over a hot fire. The bedsteads are of iron,
and each bed is supplied, in addition to the regular
bedding, with a shelf, on which is placed a pitcher
of gruel at night, and a Bible. A bed card con-
taining the age and history of patient, a box-stool
containing a urinal, which is placed upon a small
strip of carpet, and a long, full cloak to be used by
the patient while up, complete the outfit for each
bed. All patients are charged a small sum for their
board, except they be in actual labor at the time of
admission, and are only allowed to remain nine days
from confinement, except in cases of complication.
In case of suspected puerperal fever, the patient is
taken at once to the fever ward, and the clothes
thrown from the window and, together with the
ward, thoroughly disinfected. The patients before
confinement have the ordinary house diet, and after
confinement :
Oatmeal gruel, tea and toast, at - - - 8 a. m.
" " ' " at ------- ii "
Rice and milk, or bread steeped in milk
and water, at ----- - - i P. M.
Tea and toast, at------- 6 "
Pitcher of gruel, at------- Night.
The food is prepared by the cook and taken to
the ward by the assistant cook. The operating
room contains the usual number of beds and a case
for instruments, and also the sleeves and aprons
for doctor and nurse. The bed is made as is cus-
tomary in this country.
Now for the school for nurses. In the first
place, it is necessary that the applicant should
bear a good reputation, and be more than ordinari-
ly intelligent. If "accepted, she pays twenty-five
dollars, and is assigned to a room called the nurs-
ery, which is simply a large room for the nurses to
sleep in. She is then assigned a patient, and is to
attend her while the patient and her offspring are in
the house. By ten o'clock in the morning the
house must be in perfect order and the nurses
dressed, ready to receive the doctor. When the
attending physician arrives, he is met by the resi-
dent physician who attends him during the visit,
case-book in hand. At the bedside the resident
takes the head of the bed, and hands the bed
card to the attending physician who is always at the
side, with the nurse at the foot. The resident is
selected from the graduating class of the college,
and holds his position for three months. He is only
called upon to attend cases of complicated labor
and if the case is beyond him he calls upon the
Consulting Board. Twice a week the nurses attend
lectures, and they are constantly attending cases.
After having served three months and individually
confining thirty patients, they are given a certificate.
The lectures are almost all upon complicated labor,
and are attended by the students as well as nurses.
The students from the University are allowed to go
through the wards with the professor, on Saturdays,
when the stethoscope is used to find the foetal heart,
and vaginal examinations, the introduction of the
catheter, &c, are in order. A list of the nurses
is kept at the Maternatie, and those who attend to
their duties the best are the first to be recommended.
There are so many applicants for positions as nurses
at the Maternatie, that they sometimes have to
reduce the time to six weeks, in order to accommo-
date them all.
The Brooklyn Maternitie. — In our last num-
ber we announced the fact of the establishment of a
nursery department in the Brooklyn Homoeopathic
Lying-in Asylum, and intimated that other changes
would soon be inaugurated. The lady managers
have nearly completed their plans, and in a few
weeks they will throw open to the public a charity
of which the school may well be proud. The plan
involves the establishment of four departments —
the lying-in asylum, nursery, child's hospital, and
school for nurses; the whole to be known as the
Brooklyn Maternitie. For this purpose a property
has been purchased in the heart of the city for
$42,000, and, when completed, the building will be
perfectly adapted to the wants of each department.
The property is sixty feet front by one hundred and
four, and the building fifty by fifty, with an exten-
sion of twenty feet, and contains forty-six good-
sized rooms. It is built of brick with brownstone
trimmings ; is four stories high, with plate-glass win-
dows and French vestibule doorway; very com-
modious in all its appointments, and has recently
been put in complete repair. It will be occupied
about the first of June, when the house in Wil-
loughby Street will be vacated. The managers pro-
pose giving a donation party on the twenty-third of
this month, and we are requested to ask our sub-
scribers living in New York and Brooklyn, to send
anything that they think will be of service to the in-
stitution, to 50 and 52 Concord Street, Brooklyn.
There are few charities that have sprung so rapidly
into existence, and none that have had more obsta-
cles to overcome ; but the ladies .have never faltered
and they now can claim success as their reward.
The institution is managed by a board of forty
ladies, and they have appointed the following gen-
tlemen to assist them :
Officers of the Asylum — Medical Director,
Albert E. Sumner, M. D. ; Resident Physician, J.
F. Oaks, M. D. ; Medical Staff, R. C. Moffatt, M.
D., W. S. Searle, M. D., Wm. B. Garside, M. D.,
W. M. L. Fiske, M. D., D. A. Gorton, M. D. ;
Counsel, W. W. Goodrich.
Two hundred and three physicians were gradu-
ated at the different Homoeopathic Medical Colleges
in this country at the close of the last winter.
The statement of Dr. Hatton, that the foetal pul-
sations determine the sex of the child, does not stand
the test of examination.
The Medical Union.
119
(Transactions of Societies.
PROCEEDINGS OF THE BRITISH H0MCE0-
PATHIC SOCIETY.
From an article entitled Practical Remarks upon
Podophyllin, read by Dr. John Moore before the
Society,^ we make the following abstract :
1st. That Podophyllin is a very active and pene-
trating medicine, resembling Calomel in its specific
action on the liver and glandular systems, but be-
yond that the similarity ceases.
2d. That its direct sphere of action is the whole
portal system, and indirectly all other systems
connected with that, either by nervous or vascular
ties.
3d. That while the liver and gall-bladder are di-
rectly acted upon by this medicine specifically, and
led by it to discharge their contents, great relief is
given to the lungs and the brain, when oppression
of these vital organs is connected with inactive and
irregular action of the liver.
4th. That torpidity of the liver, rather than vascular
congestion, is the chief sphere of Podophyllin ; in
other words, a non-secretory state, or a state of 11011-
expulsion of the bile secretion, is the indication for
Podophyllin, and this state is indicated by sallow
complexion, furred tongue, and constipation.
5th. That the curative dose in such cases must
be brought near to the physiological, viz. : the tenth,
fifth, or fourth of a grain given once or, at the ut-
most, twice a day, and immediately arrested if diar-
rhoea appears.
6th. That the middle dilutions ought to be pre-
scribed for the other diseases in which Podophyllin
is indicated — diarrhoea, dysentery, prolapsus ani or
uteri, &c.
7th. That the diseases in which Podophyllin has
been found most serviceable by the writer are gout,
erysipelas, spasmodic and bronchial asthma, and
chronic bronchitis, and all these diseases only as an
intercurrent. (The writer has not had any personal
experience of its benefits in syphilis and goitre, and
cannot, therefore, affirm or deny its power in these
diseases. )
8th. That Podophyllin is not specially indicated
in hepatitis, nor in any of the early stages of acute
disease, save in the diarrhoea and- dysentery, for
which it is homoeopathic.
9th. That it ought never to be given where a
simple aperient is required, as in cases of undigested
food, lodgments in the ccecum and colon, &c. Its
use should be restricted to liver constipation.
Lastly, where a specific has been defined by Dr.
Drysdale, as a remedy in which the whole phvsio-
logical is absorbed into its therapeutical action,
there are some exceptions, and this I believe to be
one of those where the boundary line between the
physiological therapeutic action is not easily defined,
and where we are most certain of the therapeutic
effects when we touch the physiological sphere.
In the discussion which followed the reading, Dr.
Bayes said that his experience, though less extensive,
corroborated Dr. Moore's as to the curative sphere
\ of the drug. He had found the lower triturations
and dilutions of the greatest service in sick-head-
ache accompanied by constipation ; while the higher
dilutions had proved of great use in bilious diarrhoea
and chronic looseness of the bowels.
He (Dr. Bayes) stated that his method of pre-
scribing it in constipation and abdominal venous
congestion, was to give of the first trituration a dose
for three nights, unless the bowels moved freely
earlier, then discontinue for three or four days and
repeat if necessary ; in this way no unpleasant re-
sults followed. Dr. Bayes places reliance on Po-
dophyllin in a low dilution when the prominent
symptom is abdominal congestion, causing uterine
troubles, constipation and headache in females, and
in men, headaches, constipation, and sometimes
varicocele.
Dr. Hale disagreed with Dr. Moore ; considered
the cures due to intercurrrent remedies, and that
Podophyllin acted as an allopathic aperient, taking
the place of Castor Oil, only being more efficacious.
Thought Dr. Moore justified in prescribing it, but
also thought its action pathogenetic and not homoe-
opathic. Dr. Hale had found Podophyllin 3d,
useful in hepatic and intestinal congestion. He
thought the subject in Dr. Hughes' therapeutics as
to the action of Podophyllin on the ilium and
jejunum, would have proved of more interest if Dr.
Moore had investigated it and given his experience,
than the paper read before the society.
Dr. Hughes expressed himself as strongly op-
posed to Dr. Moore's method of using Podophyllin,
and also his explanation of its action as being non-
homceopathic and entirely at variance with the law
of similia ; and thought that the subject was foreign
to the intentions of the society, which was formed
for and in the interest and advancement of Homoe-
opathy. Thought that giving medicine in this
manner and explaining its action in this way, was a
virtual surrender of the law of cure adopted by the
homoeopathic profession. His experience in the use
of Podophyllin was very satisfactory, but he had
prescribed it homceopathically. It was indicated in
cholera infantum, rectal dysentery with prolapsus
ani, and in acute bilious attacks.
We have used Podophyllin in malarial diseases,
with decidedly beneficial effects, giving it in doses
large enough to act as a cathartic. We found that
intermittents were more permanently cured than
when treated without it. In a case of goitre we
gave the first dilution of Podophyllin four times a
day, six-drop doses, and applied, externally, a
preparation, with alcohol of one ounce of tincture to
a pint. The patient was cured in two months; no
other remedy was used. We have heard frequent
complaints of the uncertainty of its action. Dr.
Moore states, that when there is much lactic acid
in the stomach, the drug is rendered useless, as
that acid entirely neutralizes Podophyllin, while
acetic does not affect it. Certain constitutions
seem to be very susceptible to its action, while
others are not affected by it at all. Our experience
has been, that it is less satisfactory than mercury
when used in its crude form, except in certain
idiosyncrasies.
Dr. Williams gives a paper upon the treatment of
small-pox with Baptisia. Under the influence of
this remedy he says some cases appeared to be cut
short, the vesicles drying up. In the hemorrhagic
form, all these cases recovered in which Baptisia
was given. Owing to the stimulating action of the
drug, alcoholic stimulants were less needed than in
those cases treated by other remedies. The absence
of deep pitting pointed to the stimulating action of
the drug on the sympathetic nerves.
120
The Medical Union.
Dr. Dyce Brown read an interesting paper on
relapsing fever, after giving the symptoms of the
disease, which we presume are familiar to most of
our readers. In the earlier cases where the watery
diarrhoea and vomiting were present, he gave
Arsenicum with excellent results. He found no
benefit from Aconite, but much from Baptisia,
although this remedy failed in some cases. Bap-
tisia had no power in preventing the relapse, and
he only gave it during the paroxysm. Five grains
of the Hypo-Sulphite of Soda given three times a
day, he found, in the majority of cases, prevented
the relapse.
In the discussion upon this paper —
Yeldham said that, as relapsing fever seemed to be
an intermittent disease, he should treat it with
small, yet palpable doses of Quinine, Dr. Bayes
doubted whether Quinine would influence relapsing
fever favorably, and thought the symptoms pointed
more to Nux Vom., but as neither himself or Dr.
Yeldham had ever seen a case of relapsing fever,
their opinions were of but little practical value.
TWENTY-SIXTH SESSION OF THE AMERICAN
INSTITUTE OF HOMEOPATHY.
The thirtieth anniversary and twenty-sixth session
of the American Institute of Homoeopathy will be
held in the City of Cleveland, Ohio, commencing
Tuesday, June 3d, 1873, and continuing four days.
The usual preliminary meeting will be held at the
residence of Dr. N. Schneider.
There is every reason for believing that this meet-
ing will be largely attended, and that the reports of
the various bureaus will be more than usually full,
interesting, and valuable. In accordance with the
plan of the Institute — that each bureau shall select
a special subject for presentation and discussion —
the following bureaus have notified the General
Secretary of their selection of the annexed subjects :
Bureau of Materia Medica, &c. — A plan for
the more thorough and proper proving of medicines
and notation of symptoms. Provings of Eucalyptus
globulus.
Bureau of Clinical Medicine. — Phthisis pul-
monalis.
Bureau of Obstetrics. &c. — Leucorrhcea.
Bureau of Surgery. — Diseases of bones, and
their medical and surgical treatment.
Bureau of Anatomy, Physiology, and Hy-
giene.— What is the best diet for the sick in gen-
eral, and what is the best in particular diseases ?
Bureau of Psychological Medicine. — Vital
dynamics.
Bureau of Ophthalmology and Otology. —
Papers upon these subjects are solicited by the vari-
ous bureaus. Papers upon other subjects are not in-
tended to be excluded, but are likewise solicited. All
papers upon medical or surgical subjects should be
sent to the chairman of the appropriate bureau, or
to the General Secretary.
Officers of homoeopathic medical societies and in-
stitutions are earnestly requested to send a written
report of the condition, &C. , of said societies or in-
stitutions, to Dr. W. M. Williamson, No. 29 North
Eleventh Street, Philadelphia, chairman of the
Bureau of Organization, &*c.
It is hoped that physicians will make strenuous
efforts to attend this meeting of the Institute, and
do what they can to make it subservient to the ad-
vancement of medical science.
The Institute will be hospitably entertained by
the physicians and other citizens of Cleveland, dur-
ing the session.
A circular will shortly be issued by the General
Secretary, in which further information will be given,
including that relating to railroads. •
Members of the profession wishing blank appli-
cations for membership will be promptly supplied
by applying to
Robert J. McClatchey, General Secretary,
No. 918 North Tenth St., Philadelphia.
INfeuJs 3tems*
Homoeopathy in the University of Michi-
gan.— We clip the following from an editorial in
the Grand Rapids Eagle, one of the ablest and
most influential papers in Michigan, as an illustra-
tion of the way in which the medical question which
is now agitating the University of Michigan strikes
ths public Press :
"The people elect Regents of the University,
and the Constitution gives to the Regents supervis-
ion of the University, and control of the expendi-
ture of a particular fund. . Other moneys are appro-
priated by the people in the only way by which it can
be done, that is, through the Legislature, the mem-
bers of which the people elect. And the doctrine is
put forth that the people have no right to say what
shall be done with the moneys which they thus ap-
propriate. Of the reasonableness of such a doctrine
most people are able to judge for themselves. As
to the legal puzzle of the extent of the powers of
the Regents, and of the directory power of the
people's Legislature, the question must of course be
left to the Courts. The latter have, as yet, been una-
ble to decide it — and that, notwithstanding the fact
that two members of the Supreme Court were also
professors in the University. It is noticeable that
some people, professing to have a full understanding
of both sides of the question, have certainly a
wonderful capacity of assumption for one side.
Thus a horribly mangled communication in a
morning paper in this city assumes that ninety-nine
out of every one hundred of the people of Michi-
gan "have no faith in Homoeopathy!" An
imagination so capacious as that is insatiable. It
raises an unhealthy suspicion as to how so many
homoeopathic doctors contrive to live and wear good
clothes."
Home for the Friendless.— In the yearly
report of this institution, Dr. W. N. Guernsey says,
that during the five months that the Home has been
under his charge, there have been two hundred and
twenty-five cases of sickness and no deaths.
When we take into consideration that its inmates
are little children gathered from the highways and
byways of our city, the majority of whose constitu-
tions are poisoned with the diseases usually resultant
from dissipation, poverty, and familiarity with crime,
it speaks well, not only for the medical care, but for
the general management of the institution.
Dr. Leach uses the Carbonate of Lead mixed
with Linseed Oil, and applied with a camel's hair
brush, to prevent pitting in variola. This is the
white lead of the paint shops.
The Medical Union.
121
Original Articles.
THE PERILS OF INFANCY.
By Egbert Guernsey, M. D.
In our article on " The Duties of the State in the
Prevention of Disease," we referred to the terrible
fatality in early childhood, and stated that, of all
the deaths recorded as occurring in the United
States during the year i860, nearly one-half of the
entire number were under five years, and nearly
one-fourth under one year of age. There is no
animal life so helpless and whose infancy is so sur-
rounded with perils as that of the child, but this
fearful mortality shows either great defects in the
rearing of children, or that the stream of human
life is fearfully tainted and corrupt. No doubt,
much of the fatality arises fr<3m the transmission
directly of the seeds of disease from the parent to
the child. Thus children are born with weak and
unhealthy organizations, lacking in vital power
and falling victims to the first inroad of disease,
because their parents have not lived in accordance
with nature's laws, because there was a lack of
harmony in their' organizations, and because the
union may have been one of passion, of impulse, of
supposed interest without any thought of the future
of their offspring. All this is," of course, beyond our
control. The physician is seldom consulted in ref-
erence to the health and general physical condition
of parties in matrimonial alliances, and in most
cases his advice would not be taken if offered, but,
after marriage, the physician can make his influence
felt, and felt in the right direction. With the first
symptoms of pregnancy, he should be consulted,
and a general plan marked out as regards diet, ex-
ercise, and general habits of life. In this way, the
comfort and health of the mother would be infinitely
increased, as well as the probabilities of healthy off-
spring. The young married couple more frequently
err through ignorance than from any desire to
evade or neglect the new responsibilities of their
lives. The great trouble is, they shrink from ask-
ing advice, and the physician often forgets he should
be the family friend as well as the medical adviser,
that it is no less his privilege than his duty to guide
the young mother during this all-important period
of her life. He should at no time hesitate to proffer
his advice, even unasked, if he deems it necessary.
The last months of pregnancy especially, the phy-
sician should acquaint himself with the daily habits
of his future patient, her diet, manner of exercise,
and especially of the condition of her kidneys. A
few pleasant friendly visits made before the birth of
the child may be the means of saving the offspring,
or even the mother's life, or, at any rate, of saving
the mother that long train of distressing troubles
which often follow child-birth, and make life miser-
able for years. There is too great a tendency in
our profession to confine ourselves to the actual
presence of disease, which a little care and foresight
on our part might often have prevented. There is
also, to our shame be it said, too strong a tendency
to make a merchandise of our profession, and look
upon advice and watchful care only in the light of
dollars and cents. With the birth of the child, im-
portant questions arise, to be met with promptness
and decision. Has the mother a strong or healthy
constitution ? Can she in safety to herself give the
child the necessary nourishment for its growth and
health. This question, perhaps, can be decided at
once if the physician has a pretty accurate knowl-
edge of the constitution and general health of the
mother. Many a mother, by persisting in nursing
her child, has given to it her very life, the child
growing day by day in flesh and strength, while she
has slowly faded away, growing weaker and 'weaker
until the startling truth forces itself upon her friends
when she has passed beyond human aid. There is
but little danger but what the mother will nurse her
child if she can. There are but few so utterly sel-
fish, such devotees of fashion, that their own little
one nestling to their bosom will not awaken a love
they had never dreamed existed in their breasts.
The question to decide is, is she strong enough to
nurse the child ? Can she do it in safety to both ?
In the one case may she not give to it her life,
and in the other, may it not draw from the maternal
bosom the seeds of its own death ? If the ques-
tion is decided in the negative, then the physi-
cian will have to contend with the bitter opposition
of the mother to a wet nurse. True, children often
live and thrive on artificial feeding, but statistics,
both in this country and Europe, show that the ex-
periment is a hazardous one. No artificially pre-
pared food, however scientific the combination, can
take the place of the breast. In the country, with
pure air, and fresh food always at hand, children
will often thrive on artificial feeding, while in the
city the danger is immensely increased, and in
either case the experiment should not be pushed
too far.
In some cities foundlings are wet nursed, and in
others dry nursed, so that we can get at a very ac-
curate comparison of the two systems. In Lyons,
where foundlings are wet nursed almost from birth,
the deaths are from 33 to 35 per cent. In Paris,
where foundlings are wholly dry nursed, the deaths
are from 50 to 80 per cent. In New York, found-
lings were, until quite recently, dry nursed, and the
mortality was nearly 100 per cent. Now wet nurses
are employed for part of the foundlings, with a
much more favorable result. It is always well to
decide as early as possible whether it will be prud-
ent for the mother to nurse her child. Much of the
suffering to the mother, in gathered breasts, in ex-
coriated nipples, in the intense agony which every
application to the breast produces, could be saved,
and the future trouble to the child, which the ex-
periments with its little stomach in these early days
produce, be prevented if the physician had a dis-
tinct plan marked out in his^own mind, and knew
what to do and when to do it.
In the first case, answer the question is there no
constitutional impediment to the mother's nursing
her infant ? Has she the health and strength ? Will
her milk be sufficient in quantity and quality? The
latter point can be often ascertained in the last
weeks of gestation by examining the colostrum,
which can generally be squeezed from the breasts in
sufficient quantity for inspection. Sometimes we
shall be able to get scarcely a drop, and this placed
under the microscope will be found to contain but
few milk globules, and these will be ill formed. We
should expect this woman would furnish but little
milk, and that of poor quality. In other women,
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the colostrum is abundant, but thin and watery.
For weeks before the birth of the child it not unfre-
quently flows so readily from the nipples as to wet the
dress, and yet the probabilities are, that however
abundant the milk may be, it will lack in nutritive
qualities. In spite of the quantity of fluid the child
takes into the stomach, it cries, is full of pain,
grows thin, and evidently is not nourished. A care-
•ful nurse will detect the trouble, and send for the
physician. But all nurses are not careful — in fact,
many of them know about as much about the wants
and management of children as doctors know about
finance. Nursing should be a distinct profession,
with a careful training for duties second only in im-
portance, and often exceeding those of the physician.
First is very apt to come the general routine of cat-
nip and other teas, and when at last the physician
is sent for, he is apt to be deceived by the assurance
of abundance of milk, and administer drugs when
he should give food ; the darling child cries for bread,
and is put off with worse than stones.
In selecting a wet nurse, a physician with a prac-
tical eye can almost always form a sufficiently cor-
rect idea without going into the detail of micros-
copic examination. He can detect with his eye and
taste whether the milk is nutritious or watery ; by
throwing a drop on his finger-nail, if it retains a
distinct globular form it shows -its good qualities.
The litmus paper should not turn red, the tumeric
paper should turn a little brown. In the micros-
copic examination of milk, we find it to consist of
a colorless fluid, containing large numbers of minute
fat globules. Add a drop of acetic acid, so as to
dissolve the coating of the casein, the globules will
coalesce. Besides these globules, cells containing
much fat may be seen, and also masses of fat simi-
lar to those within the cells, but destitute of an en-
velop. These cells are found much more frequently
in the milk (called colostrum) which is secreted for
the first few days after parturition.
The reaction of human milk is always alkaline,
and that of cow's milk generally so. Free lactic
acid always exists in the fresh milk of the carnivora,
and sometimes in that of the cow and the goat.
The essential difference between woman's milk
and cow's milk is not so much in the difference of
milk, sugar and butter they contain, but that the
casein of cow's milk when sour curdles into large
lumps, irritating the intestinal canal, and often pro-
ducing severe diarrhoeas, while that of the woman's
milk always coagulates into small lumps or loose
flakes.
The soluble salts of human milk are chloride of
sodium, chlorate of potash, and alkaline phosphates,
and also potassium and sodium. The insoluble salts
are phosphates of liu\e and magnesia, and traces of
the oxide of iron and of fluor.
What shall be the food of the nurse, and is it
wise to urge and whip up the secretion of milk
with alcoholic stimulants ? The food should in
all cases be easy of digestion and selected with
particular care to its containing those elements
of nutrition, in a form easy to assimilate, so essen-
tial to the healthy growth of the child. As a
general thing, I have but little faith in alcoholic
stimulants. At times when the system is exhaust-
ed, they are needed to give temporary strength, and
in persons who have been accustomed to the daily
use of beer it would not be wise to discontinue it,
but, as a general thing, when the milk glands will
only secrete when whipped up by alcoholic stimu-
lants, another nurse should be found. This plan,
long continued, will not only tend to injure the
mother but the child.
In artificial feeding, we try and imitate as nearly
as possible the mother's milk. Cow's milk contains
less water and sugar than human milk, but more
butter, casein and salts ; water and sugar are added,
but I much prefer the sugar of milk to the cane
sugar. The milk is less liable to become acid in
the stomach. I have frequently found where the
casein would form in large curds when the food was
sweetened with cane sugar, if sugar of milk was
used the digestion seemed to be perfect. The milk
of the goat and the ass have been recommended in
the place of cow's milk, but chemical analysis and
experience show that they have no advantages in
quality. The cow shut up in the stall in the city is
apt to give acid milk, while the cow grazing in the
pasture, and allowed to live mostly in the open air,
gives milk that is alkaline. There is no advantage
in cities in keeping a* cow, as it must be more or less
closely confined in a stable. The country milk is
much preferable, and thanks to the ingenious pro-
cess of condensing, it can be kept sweet and pure
for a long time. Condensed milk in large cities is
undoubtedly preferable to that brought over the
roads in its natural state. It is somewhat liable to
constipate, but this can. be remedied by the addition
of sugar of milk. In condensing, out of every four
quarts, three quarts of water are taken in such a
way as not to injure in' the least the nutrition of the
milk. Add three quarts of water to each quart of
the condensed milk, and you have pure milk as it
comes from the cow. Milk for children should al-
ways be alkaline, and every nurse should be taught
to test it with litmus paper (which should not turn
red) before it is used. If it is slightly acid, not
enough however to be apparent to the taste, it can
easily be rendered alkaline by the addition of lime
water or a little soda, but if the acidity is apparent
to the taste, it should be at once rejected. Ex-
perienced writers have placed great stress upon the
danger of overfeeding. Where children are nurs-
ing the breast, in my experience, there is far more
danger in underfeeding than in overfeeding. A babe
of a month or two old should be nursed every two
or three hours ; six months and over, five or six
times in the twenty-four hours. If the child cries
from hunger, it is an indication it has not been suf-
ficiently fed. No mother need ever mistake the cry
of hunger. It is different from every other cry. If
there is not nourishment enough in the breast, and
yet what there is secreted is of good quality, help
it along with carefully prepared food, lengthening
out the intervals between nursing the breast so that
when it does take hold it gets a full meal. It is not
wise to feed with cow's milk while it is nursing the
breast, but barley water, arrow-root, biscotine, farina,
corn starch, imperial granum, or any of that class
of food can be given. When children are brought
up on artificial food, the above rule holds good as
to the times of feeding. At first the food should be
made half milk and half water. As they get to be
five or six months old, I prefer combining barley
water with it in the proportion of half barley water
to half milk with a little salt, and sweetened with
sugar of milk, if loaf sugar is found to disagree ; or
the milk can be given pure. Oatmeal is a good sub-
stitute for barley when the bowels are costive, or the
The Medical Union.
123
food can be sweetened with a little white flake
manna.
At six months, or even before if the child is weak,
give it every day a little beef tea, either alone or
in its regular food. It will add vastly to the
strength of the child, and render it less likely to fall a
victim to summer diarrhoea. Always in directing the
food of an infant, take into consideration its constitu-
tion as inherited from its parents. When the milk
passes the child in large curds, discontinue it for a
time, substituting cream or some of the forms of
food enumerated above. Dr. Meigs, in his work
on diseases of children, recommends a preparation
which he thinks agrees with the digestive system
better than any other kind of food. He says: "A
scruple of gelatine (or a piece two inches square of
the flat piece in which it is sold) is soaked for a
short time in cold water, and then boiled in a half a
pint of water until it dissolves. To this is added,
with constant stirring, and just at the termination
of the boiling, the milk and the arrow-root, the latter
being previously mixed into a paste with a little
cold water. After the addition of the milk and
arrow-root, and just before the removal from the
fire, the cream is poured in and a moderate quan-
tity of loaf sugar added. The proportion of the
milk, cream and arrow-root, must depend on the
age and digestive powers of the child. For a
healthy infant within the month, I usually direct
from three to four ounces of milk, half an ounce to
an ounce of cream, and a tea-spoonful of arrow-root
to half a pint of water. For older children, the
quantity of milk and cream should be gradually in-
creased to half or two-thirds milk, and from one to
two ounces of cream. I seldom increase the quan-
tity of gelatine or arrow-root. " I can add my own
testimony to the excellence of this food in delicate
infants. In vigorous children, the other forms of
food enumerated above are quite sufficient, and are
much more easily prepared.
Liebeg recommends a soup for infants which he
has studied out chemically, and believes to be the
best possible substitute for human milk. Possibly
he is correct, if the child could only be induced to
take it, or if it could be retained on the stomach,
but I have never yet seen a child whose stomach
would retain it, even if you could persuade it to
swallow the disagreeable mixture. When the pre-
paration was first made known, with the utmost
veneration for the great Liebeg, I prepared a quan-
tity of it for the delicate infants in the Home for
the Friendless, hoping that science had at last pre-
pared a food so much needed by these little sufferers.
Fearful that if intrusted to the cook there might be
a failure, I went into the kitchen to superintend the
preparation. The mixture was at length completed
according to rule, the cook grufly informing me
" that if them young uns was such blasted fools as
to eat such stuff, they might as well die as live."
But very few of them would touch it, and those who
did kept me up all night attending to their vomit-
ing and purging. Where milk disagrees with a
child, I have found a very excellent food is bread
jelly. A quantity of the soft part of a loaf of bread
is broken up and boiling water poured on it, when
it is allowed to steep until the whole is soft. The
water is then strained off and fresh water added.
After boiling slowly for a few moments, the water
is turned off, and the bread, in cooling, forms a thick
jelly. This may be prepared with a little water,
sugar and salt, and perhaps a little milk, but this
should be left out if the curds are seen in the move-
ments.
L believe by following these simple rules many
lives could be saved, and the immense fatality
among children reduced at least one-half. Parents
err through ignorance. Death comes often with
swift and sure footsteps, laughing to scorn the skill
of physicians and the watchful and judicious care
of parents and friends. Human skill has as yet de-
vised no remedy that can always save these little
ones, withering at the touch of Death. The blow is
too quick and too sure. It is then we can only bow
our heads in humility and feel how powerless
we are to save, how much we have to learn. But
-Death comes often too when his footsteps might
be turned aside and the little ones saved. The
great fault of our profession is neglect, neglect
in little things, in failing to appreciate the watch-
ful care necessary in rearing children, and to check
this fearful sacrifice in human life. We grow wild
over some grand operation, performed perhaps for
once in a lifetime, and spend days in careful inves-
tigation of some rare cases, hunting the world over
for a remedy, while, at our very thresholds, these
little children, with their pale pleading faces turned
up to us, are dropping from our sight by hundreds
and thousands. And yet we could save them if we
were not too busy in looking after what we call the
great things of our profession.
We are like Plato, reasoning upon the immortal-
ity of the soul and the loftiest truths of philosophy,
while within sound of his voice, as its clear accents
rung through those classic groves, thousands of his
countrywomen were living and dying in a state of the
most abject ignorance and squalid misery.
It may be in the above article I have advanced no
new thought, made no new suggestion, but old
truths when forgotten or neglected will bear repeat-
ing and urged with renewed force and strength.
With proper attention to warmth, ventilation and
diet, but little medicine will be required. In the
diarrhoeas of summer, arising as most of them do
from atmospheric changes and improperly prepared
food, a few drops of brandy or whiskey in water will
form an excellent stimulant, and often be all that is
required. Iris is an admirable remedy in slight
gastro-enteric troubles, the nausea, pain in the bowels
and diarrhoea rapidly disappearing under its influ-
ence. The attention of the physician will also be
directed to mercurius, ipecac, arsenicnm, colocynth,
chamomilla and china, each having its specific in-
dication. In general nervous irritability or spas-
modic pain a little musk acts very kindly, while if
the head should be much affected, Belladonna or
Coffea may be more indicated. In severe forms of
constipation, I have found decided benefit from
Lycopodinm and Podophyllum 3d, and in obstinate
cases have fed the child with sweet-oil made thick
with sugar. In these cases the oil and sugar
have not only acted as a laxative, but also as nutri-
tion. In a future article, I hope to speak more at
length of the medical treatment of children.
Brain Diseases. — Dr. Charles Elam, of London,
says, that in England while the population during
the past thirty years has increased thirty per cent.,
the mortality due to brain disease has multiplied
nearly four-fold. In our large cities in this country,
the per centage of increase is nearly the same.
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CLINICAL CONTRIBUTIONS.
By Dr. Dittrich, of Dresden.
(Translated by W. N. Guernsey, M. D.)
From the month of June, 1865, until May, 1866,
there appeared in the place of my former residence
and the adjoining district, an epidemic of scarlet fe-
ver, which, extending from the north-west to the
south-east, developed into such a malignant type,
that I knew of cases where healthy children, within
three hours, were struck with death. If I do not now
express my opinion decidedly upon the character of
the disease, as frequently such epidemics are observ-
ed, yet I will cite a case which occurred in my own
family.
My eldest daughter, then thirteen years old, had,
with both of her sisters, safely overcome the scarlet
fever. The albuminuria, which, in spite of the great-
est care, had set in, had also disappeared; and as
she had kept her bed over five weeks, anticipated
getting up in a few days. On the day previous to
the one to end her confinement to her bed, she
complained early in the morning before my depart-
ure upon my round of visits, of some pain in the
forehead ; yet in such a manner that I feared no evil
consequences, as the cheerfulness of her disposition
as well as her general condition was' undisturbed.
Four o'clock in the afternoon, I was sought out by
a messenger with the sad intelligence that my daugh-
ter had been seized with convulsions, and lay at
death's door. Having hastened home with the
greatest speed, an old allopathic colleague, whom
my wife, in her anxiety, had called from the neigh-
boring village, met me, saying that within half an
hour my child would be beyond recovery. After
my departure, the headache had increased ; at one
o'clock blindness in both eyes had suddenly set in,
and after two, convulsions occurred. The remedies
administered by my wife, Bella. , Hyoscyam. , had had
no effect. The aspect of the patient was terrible to
me, as the child in the morning so gay and happy,
now lay pale and disfigured before me in the most
ghastly convulsions. The spasms were principally
manifest on the face, the head (which was drawn
in every direction), and in the arms. In this terrible
position, not even hoping for recovery, I seized upon
Moschns 1, as different derivations had already been
prescribed by my colleague, and gave as much as
a grain. It was not long before sleep came, the
severe convulsions began to abate, the pulse rallied,
the breathing became freer, and in about an hour
afterward, my child, which so short time ago lay
dying, opened her eyes and asked what had happen-
ed to her, that she had slept so softly and quietly.
There was no remembrance of the terrible past, a
feeling of weariness was only present. The urine,
which for many days previously had contained no
albumen, showed it again on the next morning,
which entirely disappeared under the use of Arsen.
The rescue of my child I owe to the Moschus
alone. Whether it will help in all cases arising
from similar causes, I cannot positively say, but ac-
cording to the provings, we may assume that it is
altogether probable.
Mr. S., a merchant, aged 42, was attacked, in con-
sequence of being chilled after a bath, by a severe
inflammation of the throat and uvula of a most pro-
nounced form. The uvula was lengthened and thick-
ened to twice its normal size, and the entire extent
of the throat, and especially on the right side, was
of a dark red color. Upon neither side, however,
was there any swelling of the tonsils. Bella., Apis.,
Merc. Sol. had relieved it somewhat, yet as the in-
flammation, as also the painfulness, was still extreme,
I tried therefore for the first time, . the remedy r
recommended by my colleague, Dr. Bolle, viz., the
penciling of the inflamed uvula with a solution of
Mercur. sublimate 1:5. The result was very hap-
py, as immediately after the first application an
abatement of the swelling and inflammation began;
and after its repetition on the following day, all the
symptoms disappeared, and the patient felt entirely
well. I myself was thoroughly convinced of the ef-
ficacy of the remedy from the great rapidity of its
action.
As a very effective remedy for the cure of Chorea,
I may mention from my own experience, Stramo-
nium, by which I have restored old, chronic cases
which were merely dragging out their existence
under the care of allopathic physicians.
A carpenter's son, aged 1 2 years, was brought to
me from a neighboring town, who was suffering
with St. Vitus' dance. He had been treated allo-
pathically nearly half a year, and was so reduced in
strength that he had to be fed and carried like a
little child. As he was ordered to be sent to Leipzig
to use the cold baths and douches there, the parents
did not coincide with this treatment, and determin-
ed as a last resort to try homoeopathy. The whole
body was in constant convulsions; with every at-
tempt to speak, the tongue moved to and fro, and
only slowjy and laboriously could words connectedly
be spoken. I gave Stramonium 3, three drops in a
little water, morning and evening; and nearly three
weeks afterward, all of the symptoms had disap-
peared, and only lassitude remained ; and the un-
fortunate boy rejoices to-day in the most perfect
health.
Another form of convulsions I observed in a
maiden of twenty-one years, which I do not class
under chorea but rather designate it as erotic, as
they generally occurred only when gentlemen were
present in the room. She was well formed, a bru-
nette, and of a gentle disposition. She had passed
through the ordinary diseases of childhood happily.
Occasionally, without any accountable cause, she
was attacked with twitching in the arms and feet,
which, although they gave the patient unpleasant
sensations, were ignored by her relatives, as they
were not severe and of seldom occurrence. More-
over, it may be further mentioned, there was no
evidence that onanism had ever been practiced.
Suddenly, however, after a slight fit of anger, a
characteristic picture of the convulsions occurred.
After isolated twitchings in the arms and feet, and
a stretching and extending of the limbs had taken
place, the whole body was,, as by an electric shock,
thrown upward ; and now the most heterogeneous
movements of the arms and of the upper portion
of the body began. The arms, rigidly thrown out
at equal distance, whirled with great rapidity around
each other, then were suddenly torn apart and'held
horizontally, and, then clapped together. Now, the
whole upper half of the body was bent so far back-
ward that one would think the spine must break,
and then, again, forward as far as bending was pos-
sible ; then fell slowly upon the side, and the hands
would be flung out convulsively on both sides, with f
such force, . that everything must be removed to
protect them.
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125
If one wished to prevent these motions, she was
entreated to desist lest pain in the limbs might set
in. These convulsions occurred several times daily,
but never at night, and left behind a feeling of las-
situde that compelled her to rest on the sofa for a
length of time. The feet were more exempt from
these convulsions, and on lying down could be kept
quiet. An examination of the spinal column re-
vealed nowhere any pain, and all the other organs
performed their functions normally. I had already
seen many patients in epilepsy and St. Vitus' dance,
but such a complicated contortion of the whole
body, with possession of full consciousness, I had
never observed. The administration of Cupr. met.,
Zinc, Ignat., Hyoscyam., alleviated the attacks and
prevented their frequent occurrence, but a radical
cure resulted only from Sframon. 006, six drops in
a cup of water, a tea-spoonful every two hours.
This occurred some fourteen years ago, and the
patient has been well ever since, and is the
mother of a healthy boy.
Mr. C, a strong, vigorous man, forty-two years
old, complained of severe pain in the region of the
kidneys.
An examination of this part and of the urine, as
also the character and intensity of the pain, per-
mitted me to diagnose the disease as renal colic,
due to gravel in the kidney, which was also con-
firmed, as fine sediment was found in the urine. As
there was extreme sensitiveness to the gentlest
touch, the patient was given Bellad. 3, by which all
sensations of pain were alleviated. Lycopod. 006
was then given, and calculi were passed which were
both round and angular and as large as peas.
Under the continued administration of this remedy
they were voided at different intervals, and frequent-
ly accompanied by severe pain. During the past two
years none have been passed, and the patient seems
restored to perfect health.-
A similar case, and, indeed, the first in my own
practice, I saw when assistant to my distinguished
teacher, Dr. Haubold. As I do not now know the
intimate details of the case, I will only mention the
remedy which Dr. Haubold prescribed with very
good effect, viz. : Nux Moschata. Under the use
of this remedy, calculi were continually passed, and
the colic cured.
A SUBSTITUTE FOR THE TRACHEOTOMY TUBE.
By John C. Minor, M. D.
In presenting to the profession a new instrument,
I believe an apology is due. The profession has al-
ready been presented with too many instruments, a
large majority of which are practically useless. I am
conscious of having perpetrated my full share of these
mechanical absurdities, and can only claim the merit
of recognizing their inefficiency and refraining from
advancing their delusive merits upon my confreres.
In the present instance, however, I believe the sim-
plicity and efficiency of the new instrument and its
obvious advantages over the one in common use,
will commend it at once to those whose practical ac-
quaintance with operations upon the windpipe thas
made them familiar with the imperfections of the
ordinary tracheotomy tube.
What are the disadvantages of the ordinary tra-
cheotomy tube ?
1 st. It is difficult to introduce. 2d. It is liable to
become obstructed by mucus and shreds of mem-
branous exudation. 3d. It is difficult to slear it of
these obstructions, thus rendering death from suffo-
cation depending upon an obstruction of the tube
a not unfrequent occurrence. 4th. It prevents the
free passage of air through the natural outlets, — the
patient must breathe through the tube or not at all.
5th. It hides from view the walls of the trachea
or larynx, thus interfering with local applications
and with the diagnosis and prognosis of the disease.
6th. It is a complicated and costly instrument, ad-
mitting of no modification in shape or size, render-
ing it necessary for the surgeon to have always at
hand several tubes of various dimensions and curves
to suit the size and depth of the particular trachea
upon which he may be called to operate.
In constructing a new instrument, I have kept the
imperfections of the old one steadily in view, and
have endeavored to avoid them. Before describ-
ing the instrument, a brief consideration of the
principles of its construction will not be out of
place.
The operation of tracheotomy may be divided into
two periods. In the first, we cut down to the trachea
and open it. In the second, we hold it open. This
applies as well to laryngotomy and laryngo-tra-
cheotomy. It is important to recognize the fact that
the tracheotomy tube was devised for the purpose of
meeting the second indication, namely, to hold open
a wound in the trachea so that the air can pass in
and out of the windpipe through the wound. This
is all that any instrument can accomplish. If it does
more than this it does too much ; if less, it does too
little. When we consider the objections I have
already mentioned as existing against the ordinary
instrument, it will be seen that, while the tube holds
open the wound, by blocking up the superior and
natural outlets, and by offering an obstruction to the
escape of exuded matters through the artificial open-
ing, it does too much. The fault in the instrument
is the fact that it is a tube. When the fingers are
used to hold a wound open, we use a most perfect
instrument for the purpose, provided the wound is a
large one. But in such small wounds as those we
are now considering, we are compelled to substitute
retractors for the fingers. Ordinary blunt hooks,
however, will not hold the wound open, because the
trachea, being an elastic tube, gives upon traction, so
that the blunt hooks are apt to slip out, and will cer-
tainly do so if the transverse diameter of the dilated
wound equals the diameter of the trachea. The re-
tractors must, therefore, project down into the tra-
chea, beyond the wound, in order to hold their
position ; in brief, they must have the curve of the
tracheotomy tube. Single wires cannot be used for
the purpose, because the free extremity is apt to
produce irritation or ulceration by pressure on the
mucous membrane, — hence the failure of Marshall
Hall's instrument. The retractor must have no free
points. By bending an ordinary hair-pin at right
angles we have an excellent retractor, but it requires
for our purpose a peculiar curve of the arm that ter-
minates in the rounded extremity. Having decided,
then, that a pair of wire retractors are best adapted
to meet the requirements of the operation, it only
remains to consider how these shall be made to keep
the wound open, — whether the dilation shall be fixed
or elastic — by means of screws or a spring. This
point is briefly disposed of by the results of experi-
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ence, continuous elastic pressure, by means of a
spring, having been found to be dangerous to the
vitality of the parts pressed upon when used for any
thing more than a mere temporary dilitation. We
have now considered all the essential features of the
new instrument, viz. : a pair of wire retractors, of
suitable size and shape, capable of being introduced
into the wound closed, and of being expanded to any
desired extent after introduction, and fastened apart
by screws.
A hollow rod (A), slightly curved and having a
screw (B, B) set at each extremity, supports the
two wire retractors (C, C). The retractors are of
stout German-silver wire, and are so bent as to pre-
sent a supporting arm (£), which is received into
the hollow rod (A ) and can be fastened there at
any point by a turn of the screw. The transverse
portions (C) of the retractors furnish a point of ap-
pliance for the tapes used to secure the instrument
in position. The descending or tracheal portion
(D, D) is curved like the ordinary tube.
When this instrument is used, the tracheal arms
(D, D) are first brought close together and fastened
so by a turn on the screws. Then they are inserted
into the wound and passed down the trachea till the
transverse portion (C, C) arrests their further prog-
ress. The screws are now to be loosened — it is
better to loosen only one of them — and the wound
dilated sufficiently by drawing gently on the retrac-
tors. The retractors are to be now fastened and the
whole instrument secured by tapes around the neck.
But one caution is necessary, — never open the tra-
chea until the haemorrhage from the previous incis-
ions has ceased.
Each instrument has three pairs of retractors of
different sizes, and the material from which they are
constructed, while stiff enough to accomplish the
object desired without bending, is, at the same time,
easily bent with forceps to any curve or angle desired.
In operations upon the windpipe for the removal of
foreign bodies, this instrument is invaluable. Messrs.
Stohlmann, Pfarre & Co. have made this instrument
for me from my models, and they inform me that the
cost of the new instrument will be about half as much
as that of the old one.
I believe that I may claim for this instrument that
it is easier to introduce than the old one; that it is
less liable to become clogged ; that it allows of per-
fect access to every part above and below the open-
ing ; that it is adapted to all cases in which the wind-
pipe is to be opened, for whatever purpose, and while
it is thus a more valuable instrument than the ordi-
nary tracheotomy tube, it is at the same time a much
less expensive one.
CLINICAL SURGERY.
REMOVAL OF HALF OF THE FRONTAL BONE. — RE-
SECTION OF THE OS CALCIS. — AMPUTATION AT
THE KNEE JOINT. — INGROWING TOE-NAILS. —
THE TREATMENT OF HIP-DISEASE WITHOUT
SPLINTS.
By John C. Minor, M. D.
i . Removal of Half of the Frontal Bone. — Nelson
Crawford, 4 years old, residing at Harlem, and a
patient of Dr. Demarest, was brought to me Dec.
31st, 1870. Three months before, he had fallen
from a truck, striking his head upon the curb-stone,
and cutting a deep gash over the left orbital promi-
nence down to the bone. The haemorrhage was
excessive, to such a degree that it could only be ac-
counted for by the probability of its origin from one
of the veins of the diploe. The bleeding was finally
controlled by pressure, and the wound dressed with
ordinary adhesive strips. The child was soon able
to play about again ; but in the course of a week or
two, pus began to develop under that portion of the
scalp covering the left half of the frontal bone, and
discharged in three or four places, forming fistulous
sinuses, leading to the bone, which refused to heal.
In this condition the patient was brought to Dr.
Demarest, who syringed out the fistulas with a weak
solution of carbolic acid, and thus healed some of the
openings. The persistence of the discharge from
some of the sinuses led the doctor to conclude that
there must be some foreign body or a splinter of
bone under the integument requiring removal, and
he therefore brought the case to me for operation.
On examination, I found three fistulous openings
situated near the line of the coronal suture upon the
frontal bone. The probe came at once in contact
with the frontal bone, which was found to be necrosed.
Just underneath the openings, the bone was per-
fectly smooth ; but where the bone was completely
covered by integument, and subject to a continuous
maceration in pus, it was roughened. I placed the
child under chloroform, and with a single incision,
three inches long, converted the three openings into
one. The bone was now found to be freely mova-
ble, but the extent of the incision was not sufficient
to allow me to remove the dead mass. My first
incision had followed the line of the coronal suture,
nearly to its junction with the sagittal suture. Start-
ing from the upper extremity of this cut, I now
carried my incision two inches downward parallel
with a line projected forward from the sagittal
suture. Lifting up the angular flap thus formed, I
was able to reach the superior boundaries of the
necrosed bone. This was now tilted up on a direc-
tor, and with the utmost care the whole mass of
bone was lifted from its bed and removed. The
dura-mater was exposed throughout the entire ex-
tent of the huge wound, and the movements of the
brain were plainly seen under the membrane. The
necrosed mass embraced the entire thickness of the
bone, the outer and inner tables ; it had the rough,
worm-eaten appearance commonly found in ne-
crosis, and measured four inches in length and two
inches and a-half in breadth, and constituted nearly sw
half of the frontal bone. >u
The wound was kept in apposition by silver sutures,
allowance being made for the exit of pus at the most
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127
depending part. It healed by second intention,
leaving a scar that was hidden by the hair. New
bone was completely formed within eight weeks.
2. Resection of the Os Calcis. — Sophia Heyer, 16
years old, residing at Greenpoint, was placed under
my care Oct. 29th, 1870, by Dr. Henry Holt, for
the treatment of caries of the os calcis. Fourteen
months before, she had sprained her ankle. From
this she recovered in a few days, but about two
months after the sprain occurred she began to com-
plain of pain in the ankle, and a more serious trouble
developed. The parts became rapidly swollen and
gave her intense pairs . The swelling, which was most
prominent just below the external maleolus of the
right foot, was freely lanced and evacuated of a large
quantity of bloody matter, with marked relief. A
fistulous opening remained, however, and from time
to time little granular particles of dead bone would be
discharged. The pain was no longer acute unless she
attempted to use the foot, but the foot was perfectly
useless and her general health was rapidly deterio-
rating. In this condition she was brought to me, a
thin, weakly girl, hobbling around on a pair of
crutches, with one useless foot, and bearing the marks
of suffering and exhaustion upon her countenance.
On examining the foot I found extensive caries of
the os calcis, and advised an immediate operation,
which was promptly agreed to. Having placed the
patient under chloroform, I began my incision at
the outer edge of the insertion of the tendo-achillis,
carrying it first downward and then along the ex-
ternal and inferior edge of the bone till near its
articulation with the cuboid ; the incision was then
carried upward a short distance above the inferior
surface of the bone. During the incision, and sub-
sequent dissection of the flap, the greatest care was
used to avoid the peroneal tendons, and I was able
to turn up the flap and expose the bone without
having divided a single tendon or severing any artery
requiring ligature. With the gouge and trephine
I now removed the external face of the bone and
gouged out its carious contents. In order to do
this effectually, I left nothing but a mere shell of
bone in the wound, and part, even, of that was dis-
eased. Having made a counter opening through the
internal face of the bone, I filled the cavity with
oakum, approximated the edges of the wound loosely
with silver wire, and put on a light dressing of tepid
water. The after-treatment was of the simplest de-
scription.
Three months afterward, the girl again presented
herself to me, walking without crutches, improved in
appearance, and gaining daily in health and in the
use of the foot. NewT bone had formed, and there
was not the slightest shortening or deformity. The
process of restoration was not fully complete, for the
external fistula still remained open, but the case
was evidently approaching a perfect cure with great
rapidity.
Although this case was operated upon without hesi-
tation, the plan of the operation, and, I believe, the
excellent termination as well, was the result of a very
close observance and study of the various methods
of operation in similar cases. I have performed the
operation of removing the os calcis entire in two in-
stances, and have witnessed the operation by other
surgeons six or seven times. I have at hand, also,
most of the recorded cases of the French and Eng-
lish surgeons. On this basis I have made up my
mino^ that a complete extirpation of the os calcis is
a bad operation, so far as results go, and that the
modification which I adopted in the case recorded
above, is in every way better. What are the require-
ments of an operation in an ordinary case of caries
of the os calcis ? To remove the dead bone in such
a way as to preserve the periosteum, and thus allow
of the reproduction of new bone, and at the same
time to preserve unimpaired the insertion and con-
tinuity of the tendons. In my experience, it is im-
possible to strip the periosteum from the bone when
operating from the outside of the bone, except to
leave it in such a torn and. ragged state as to destroy
entirely all chances of osseous reproduction. The
irregular and rough surfaces of the bone make this
difficulty sufficiently obvious. Therefore, follow-
ing the example of Sedillot, I would approach the
periosteum from the inside of the bone, scooping
the bone out, and I would do it because I be-
lieve that it is best to operate on the diseased side of
periosteum; the other side contains our sole dependence
for nutrition and reproductio7t, and must be inter-
fered with as little as possible. The advantage of
preserving the tendo-achillis undivided and leaving
it attached to diseased bone until the diseased is re-
placed by healthy structure, the immunity of other
tendons and important parts from injury, and finally
the good result obtained, appeal strongly in favor of
a general adoption of the method I have described
in the operative treatment of these cases. I claim
no merit of originality in this operation; it is certainly
not a brilliant one to witness, but in its results I be-
lieve it will surpass any of the ordinary methods.
3. Amputation at the Knee Joint. — Auguste H — ,
a German boy 12 years old, had injured his leg
slightly by a fall six months previously. Periostitis
was rapidly followed by necrosis of the tibia, and
when he was brought to me, the whole shaft of the
bone was dead, the head of the bone was diseased,
and the fibula was also invaded by the necrosis for
about one-third of its extent. The anterior surface
of the tibia was exposed to the extent of about six
inches. I amputated at the knee joint, making a
long anterior and a short posterior flap, removing
the patella. The case did well eventually, but had
a narrow shave for it from erysipelas, due, as I be-
lieve, to contagion from occupying a bed that had
formerly been used in a puerperal case. Cantharides
was of the most service in controlling the erysipela-
tous trouble. Another difficulty, a very common
one after amputations, was the spasmodic twitching
or jumping of the muscles. Sometimes Nux- Vo?nica
controls this very painful symptom, but usually I
find that by putting a wide strip of adhesive plaster
on each side of the limb, and uniting them below, so
that extension can be made by a weight and pulley,
a gentle and continuous traction on the muscles
quiets the irritability. This operation was performed
at the Hospitaf for Women, Nov., 1871.
4. Ingrowing Toe- Nail. — I have rarely had oc-
casion of late to operate in these cases. The treat-
ment I adopt is so simple and effectual that I can
recommend it confidently in all cases of this dis-
tressing affection. My treatment is to apply Collo-
dion to the under surface of the toe. The collodion
should not be mixed with anything to make it flex-
ible, for the virtue of the application depends on
the contractile power of the collodion, which is im-
paired by any admixture. The application should
be made to the under surface, and may extend part
way up the sides of the toe. It immediately con-
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tracts, and the toe loses at once its blue congested
appearance. The contraction draws the flesh grad-
ually away from the edges of the nail, and at the
same time exerts a beneficial action by mere com-
pression. I apply the collodion once or twice a
day, two or three coatings each time. I have cured
in two weeks, by this method, a case of ten months'
standing, in which the sides of the nail had been
removed, and treatment by caustics had been tried,
without effect, by other surgeons. This is not, of
course, always a permanent cure, but if any tend-
ency to a return of the trouble occurs, a prompt ap-
plication of collodion, as directed, will generally
stop it. It is rapid, painless and effectual. With
reference to operations in these cases, I never ex-
tract the nail, nor do I follow any of the methods
which make the nail the basis of operation. It is
in every way better to shave off a sufficient quan-
tity of the soft tissues at the side of the nail, so that
after the wound has healed and contracted there is
nothing left for the nail to grow into. This method
is less painful, equally rapid, and more certain than
any other operation.
5. The Treatment of Hip- Disease without Splints.
— For three years past I have been treating all my
cases of hip-disease without splints, and my experi-
ence has convinced me that my treatment is safer,
less expensive, and gives better results than that in
general use. I keep up extension all the time, at
night by the ordinary weight and pulley, and dur-
ing the day by a very simple contrivance, which I
will presently describe. The patient is never con-
fined to bed, except when the formation of an ab-
scess, or the accession of constitutional symptoms
of a severe type, or the aggravation of the local
symptoms by motion, render such confinement ne-
cessary for a time. Contrary to the general weight
of testimony on the subject, I open the abscesses
as soon as they are fully developed, and whether it
is the Silicea, the Calcarea, Colocynth, or other
homoeopathic remedies that I administer according
to the indications, or whether it is the fact that this
practice is based on sound pathology, I can only
remark that I have never seen any bad results de-
pending upon the evacuation of the abscess. There
is generally a hectic fever both before and after the
abscess is opened, and it may increase in severity
for a few days, but the properly selected homoeo-
pathic remedy will always check and stop it — China,
Arsenicum, Pulsatilla and Ipecac., are among the
remedies that may be needed for this condition.
It is impossible to individualize medicines for
particular conditions. Each case is a study by itself.
The symptoms are the surest guide to the proper
remedy, and often enough I have been surprised to
find the study of these symptoms leading me to
the selection of some remedy which would never
have occurred to my mind from a consideration of
the pathological condition alone. Thus, I had re-
cently one little patient who presented the following
symptoms : Hectic fever followed by cold perspira-
tion on the back, and headache especially in the
occiput ; excessive thirst ; nausea ; diarrhoea, with
much prostration ; flexion of the leg upon the thigh,
with painful cramps in the calves of the legs at
night. Secale cornutum was the remedy, and it re-
moved all these symptoms in less than two days.
The method which I use for keeping up extension
during the day, is to attach a wedge-shaped piece
of lead to the sole of the shoe of the affected limb,
and on the shoe of the sound limb I put a cork sole
of two inches or more, so that when the patient
stands on the sound leg the loaded foot of the affect-
ed side swings clear of the ground. Two crutches 4
must, of course, be used for locomotion. Thus a ^
continual extension is kept up when the patient is
out of doors. A reclining chair or lounge, fitted
with weight and pully, is used when the patient is
not walking. The weight is made wedge-shaped,
so that the strain comes directly under the heel.
From two to five pounds may be used in this way
without inconvenience, but if there is too much
strain upon the ankle or knee joints, a strip of
English (moleskin) adhesive plaster may be placed
on each side of the limb, commencing three inches
above the knee joint, extending down near to the
ankle joint, and attached to the shoe on each side
by a strap and buckle. Thus the whole weight
tells directly upon the diseased part. The advant-
ages of this method are very plain. The apparatus
cannot slip out of place. There is no counter exten-
sion, and consequently the perineum is not excoriat-
ed by the pressure of straps and pads. There is
no pressure in the neighborhood of the joint, as in
all the popular mechanical contrivances. Motion
in all the joints is permitted, and, above all, the
patient is able to be out of doors with more com-
fort than under any other treatment. Moreover,
the exact amount of extending power is always
known and is always operative.
UTERINE POLYPUS REMOVED FROM A CHILD
EIGHT YEARS OF AGE.
By A. K. Gardner, M. D.
I WAS lately called in consultation by Dr. Warner,
of East Nineteenth Street, to see a child of Mr. M— ,
aged eight years, robust and of general healthy ap-
pearance. She had been the objeet of no little
solicitude by reason of a long-continued vaginal
discharge, reported to have originated as a simple
leucorrhoea, such as is not unfrequently seen in young
and strumous children. In its incipiency, it was
white and simple, then gradually becoming more
and more yellow, thick, somewhat offensive, and,
finally, accompanied by frequent hemorrhages, and
to such an extent as to cause some little anaemic
appearance, with debility.
Examination showed the vagina — which admitted
a little finger — full of some foreign growth. With-
out delay she was put under the influence of chloro-
form, this body easily recognized as a polypoid for-
mation, seized with a polypus forceps, drawn down,
twisted and removed. It was carefully examined
by Dr. J. W. Bowden, who writes as follows : "The
tumor is fibro-cellular in its character, the cells con-
tain a yellowish serous fluid and a few flocculi ; these
cysts are small, but uniform in size, and resemble
somewhat the appearance of hydatids in their group-
ing. The mass has been completely removed, so
far as I am able to judge, and I should say was of
the benign form of uterine polypi."
The tumor was not weighed, but was in size and
general appearance, shape, &c, that of an ordinary _
ovary. v.
The interest in this case is mainly its occurrence
in a child so young. It evidently originated within
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129
the uterus, for I have since been informed by Mis.
Dr. Lozier that the child was brought to her some
time previous, and examination showed no polypus
> perceptible, and this lady is too skillful a gynecolo-
' gist to have overlooked it if present.
The case is, however, interesting to the practi-
tioner who frequently is called upon to prescribe for
the leucorrhcea of infants and children of all ages,
which occur as sequelae of measles, scarlatina and
other like diseases, and is developed from the pres-
ence of ascarides migrated from the adjacent rectum,
from the presence of foreign bodies, beads, toys,
&c., placed in the vagina from. the same spirit
which as frequently thrust them into the ear, nose,
&c. ; also from the infection from gonorrhceal and
other like complaints acquired from their impure
nurses and bed-fellows.
These causes show the propriety of giving more
careful attention to these cases of children and in-
fants' leucorrhcea than is generally bestowed upon
them. We do not often find germinating beans or
polypi, but we do find them, or the like, often enough
to demand a personal scrutiny as to the cause of
such discharges. In some cases, even in the families
of the wealthy, where the mothers visit the opera
oftener than the nursery, simple water may be ad-
vantageously recommended, even if we complicate
the case by a recipe like the following : r> Saponis
Hyspan | 1, Alcohol Pur. 3 X? Ess. Jasmin q s.
Wash the part with a dessert-spoonful in a tumbler
of water, every morning and night.
CLINICAL LARYNGOSCOPY.
By E. J. Whitney, M. D., ■
Laryngoscopist to the Brooklyn Homoeopathic Dis-
pensary and Physician to the Brooklyn Hospital.
C A SE 1 . — Follicula r Pharyngitis.
Feb. 28. Patrick G., aet. 16, complains of hoarse-
ness in the early morning, and pain in swallowing ;
constant feeling of chyme in the throat, pharynx
congested, and studded with enlarged follicles.
These were each touched with Argent-nit. and
Silicea 30 prescribed.
March 3. Patient reports great relief. Continued
remedy.
March 7. Very much improved. Continued
remedy.
March 12. Pharynx clean and smooth. Cured.
Case 2. Sub acute Laryngitis.
Feb. 24. Eliza R., aet. 21, applied for relief at the
Dispensary. Larynx and chordae vocales congested,
and voice aphonic. Sensation of soreness in the
larynx, and weariness from speaking. Causticum 6.
Feb. 27. Somewhat better. Applied within the
larynx, solution of Ferri per Chloridi, and con-
tinued remedy.
Feb. 28. Much improved. Cont.
March 3. Voice entirely restored, and congestion
gone. Discharged.
Case 3. Congestion Vocal Chords.
Feb. 13. David R., aet. 21. Both vocal chords bright
red in color. Meeting anteriorly, they gradually
diverge toward their posterior attachments, produc-
ing aphonia, Belladonna 1.
Feb. 14. No improvement. Gave inhalation of
Ferri per Chloridi, and prescribed Mur. Protoid 1.
Feb. 17. Much better. Caust. 3.
Feb. 18. Vocal chords quite white, and aphonia
gone. Discharged.
Case 4. Ulcerated Tonsils and Chronic Pharyn-
gitis.
Feb. 13. James D., aet. 21. Both tonsils present
flat ulcerated surfaces, and are slightly enlarged.
Mer Solub. 3.
Feb. 27. Patient so much improved that he con-
siders himself well. Mer. Solub. 30.
Case. 5. Dysphagia.
\ Dec. 2, 1872. Thomas F., aet. 56. Patient com-
plained of great difficulty in swallowing, and always
pain. This condition has existed for nine months.
Patient states he prefers fasting rather than eating,
so great is the pain in swallowing, and with such
difficulty is the act accomplished. Can swallow
fluids more easily than solids. Great pharyngeal
irritability and general congestion of the fauces and
larynx. Nux- Vomica 2.
Dec. 6. Patient joyfully pronounces himself cured.
Can now swallow easily and without any pain, and
eats heartily and with relish. Cured.
Case 6. Naso Pharyngeal Catarrh. Tertiary
Syphilis.
Jan. 13, 1873. Mark McY., aet. 28. Has con-
siderable pharyngeal inflammation and follicular
enlargement.
• Feb. 3. Patient has a syphilitic history. Con-
tracted it primarily about 10 years ago. Since then
he has had swelling of the mucous membrane of the
roof of the mouth, and upon pressure, pus exudes
from the gum covering the upper incisors. Teeth
are loose. Complains of some supraorbital pain.
Acid, Nitric, 1.
Feb. 7. Pain on the orbit very severe and mouth
and throat very sore. The pain also shoots down
the cheek and through the upper teeth. Phos. 3.
Feb. 10. Pain not so severe. Teeth still loose.
Kali Iodide 1.10.
Feb. 17. Much improved. Pain gone.
100 Lafayette A vemte.
Atropine as a Means of Diagnosis Be-
tween Life and Death. — Thomas Warden, M.
D., of the British Navy, in a communication to the
London Lancet, of May 3d, suggests the action of
Atropine in dilating the pupil as a test in these cases.
If used to a person asleep or in a trance the pupils
would dilate, but in a case of actual death no such
phenomena would occur.
Chinese Use of Shad in Phthisis. — Physi-
cians of the "Flowery Land" assert that shad,
particularly shad oil, is of much efficacy in consump-
tive diseases. The fish seems identical with the
clupea of the American coast. In Shanghai it is
known as sz'-ng, shi-yii, or periodical fish ; enters the
Yangtze and adjacent waters in May, and for about
sixteen weeks is in season. The earlier in the season
it is caught the higher prices it commands. The
principal officials have the first claim for it, and it
is an article of tribute to the Emperor. In all dis-
eases in which Cod-liver oil is used, it is equally
efficacious; its alterative and stimulant properties
being closely analogous to those enumerated as com-
posing the officinal oleum morrhuce.
130
The Medical Union.
Correspondence*
A LETTER FROM JOHN CRANNELL,
CONCERNING BOSTON.
Every good Christian should go to Boston just
before he dies, so that the transition from earth to
heaven may not be too sudden. In view of the re-
cent action of the Massachusetts Medical Society in
expelling some of its members for indulging in " un-
becoming and dishonorable conduct, in practising
homoeopathy," it will not be necessary for "regular"
physicians to go any farther than Boston on their
road to glory, until they have more definite infor-
mation relative to the professional standing of ho-
moeopaths in the celestial sphere. The full report
of the proceedings of the Medical Society with ref-
erence to the obnoxious physicians, has not been
made public — and will not be. But I select one of
the unpublished speeches and give it to the readers
of the Medical Union, on condition that they keep
it quiet. For obvious reasons, I do not give the
speaker's name — it is sufficient to know that he was
a member from the suburbs.
John Crannell.
"I'm dead sot in favor of expellin' them homer-
pathies. When critters is so base as to impress the
poppylar mind with idees that run dead agin the
intrusts of the reglar profession, I calkerlate it's
'bout time to put a stopper on 'em. [Loud cheers. ]
" 'Tain't comfortin' to hear folks asayin' that too
much medicine is wus'n too little. It's money out
of pocket to foster that ijee, an' it riles me when I
see one of them homerpathies agoin' round with his
little pills instillin' sich nonsense into the public ear.
[Applause. ]
"I hain't no prejudyce as a gineral thing, but I've
had hard times sence a homerpathy doctor come to
our nebberhood — things was lovely before that time.
But arter he come, it happened that Deacon Smith's
young man was took with a sick spell. Wal, I
cleaned him out fust one way and then t'other. I
sweated him an' salivated him, but somehow 'twarn't
no use. He took sicker an' sicker, an' bime-by I ses
to the Deacon, 'your boy won't get much better, I
reck'n, seein' as how he's got the sorosis on his liver
an' peers like he mought peg out enny minit. I'll
jes' step over an' tell the parson to drop in — an'
you'll find Mr. Berryem the most reasonable under-
taker.' Waal, the Deacon said as how he'd try the
homerpathy doctor fust, though I told him 'twas
most as bad as murder to trifle so with human life.
He wouldn't argy the pint with me, but like an on-
reasonable cuss, he said he'd try the new doctor fust,
an' blackguard him arterwards, if necessary. That
boy was out agin in two weeks, as peert an' chirk as
ever. That's only one case, an' I s'pose I might tell
you a dozen or more. [Groans.]
"What I complain agin, isn't the cure, for I don't
rejyce in funerals (though I do git commissions from
Berryem), but the sassy way folks talk about its
bein' the little pills what does the business — that's
what riles me. There's no medicine in 'em, or at
any rate not 'nuff to make a man sick ; and if medi-
cine won't make a man sick, I'd like to know how
it's agoin' to make him well. I've told folks there
wasn't no medicine in them pills, an' I've warned 'em
agin atakin' of 'em on account of their bein' filled
with pizen. I've did my dooty in directin' the in-
quirin' an' ingenious minds of my nebbers towards
the eddication, pussenal charackter an' ancestors of
the homerpathy doctor, but somehow it don't work.
They want to know how it is that if there's no medi-
cine in the pills, Natur' seems to do so much more
for the homerpathy doctor than she does for me, an'
how it is, if there's pizen in the pills, that a marciful
Providence peers to keep 'em from killin'. The pa-
pers is down on us because we intend to put a stop to
sich a dishonorable practice ; but we must perform
our dooty fearlussly, for our intrusts an' our dooty
is one an' inseperable — every time. [Tumultuous
applause.] Folks is talkin' about our imitatin' the
dispersition of our ancestors, who burned all the
humly old wimmin for bein' witches, sperrit mejums,
and sich. I don't see the use of rakin' up them old
stories, but I du believe that if homerpathy had bin
aflourishin' 'bout those times, an' we'd a bin there
too, there mought a bin some medical sizzlin goin'
on, an' some of them cusses would 've bin combus-
ted. I go for puttin' 'em out, an' I want to carry
back to my nebbers the dockerments to show that
the homerpathy doctor is a dishonorable cuss be-
cause he's a homerpathy. " [Prolonged cheers and
enthusiastic applause.]
TlC-DOULOUREUX TREATED BY LOCAL APPLI-
CATION OF Ice. —Dr. Winternitz, according to the
Centralblatt, f. d. Med. Wissenschaften, No. 30,
1872, states that, at the advice of a colleague, he
treated, by the local application of ice, an obstinate
case, in a female, of neuralgia of the right side of
the face, which had resisted all the various remedies
that had been perseveringly employed. A piece of
flat, smooth ice was applied to the entire painful
side of the face, for five minutes at a time, at first at
short intervals, gradually prolonged. The painfull-
ness of this procedure may be lessened by the
patient holding in the mouth a portion of some
alcoholic fluid, which causes a glowing sensation in
the cheek. After twelve hours the pain in the lady's
face had disappeared, and had not returned during
the ten months which had elapsed at the date of
Dr. W's report. — Mittheilungen des Aerztlichen
Vereins Wien.
Re-menstruation by the Breasts at Ad-
vanced Age. — Dr. Tueffard relates {Union Med.)
the case of a lady, aged 56, in whom the menstrua-
tion had ceased at the age of 50, without any dis-
turbance of the health ensuing. Four years since
she had a superficial ulceration of the os-uteri which
soon yielded to treatment. In November, 1871, the
breasts became large and firm, with projecting
nipples, whence a fluid — at first serous and then of
a bloody color — was discharged. This discharge
continued for eight days, when it gradually ceased,
to reappear again in a month, accompanied with
cephalalgia, loss of appetite, and swelling of the
breasts. Down to the present time, it has con-
tinued to reappear every month with an almost
exact regularity, the patient being aware of its
approach almost as surely as a young woman is of
that of her menses. During the intervals the
breasts became again flaccid. There is no uterine /%
disease, and in other respects her health is quite ^
good.
The Medical Union.
13*
Che Jftebical "Union iCUnic.
^ Lines of Incision for Rapid Amputations. — In Dr.
F. H. Hamilton's excellent work, The Principles
and Practice of Surgery, we find the following :
"Amputation of the Leg in Continuity. — In
the lower third of the leg the circular amputation
ought, in general, to have the preference. In mak-
ing this operation, whether through the leg or thigh,
I have of late practiced the following method :
" The knife, instead of making the complete circuit
of the limb in a line at a right angle to its axis, is
carried upwards upon the posterior aspect through
a short curve of one, two, or more inches ; the oppo-
site extremity of the circular incision terminating in
the same manner, and at the same point. The ad-
vantages of this method are, the greater care with
which the skin is rolled back, rendering the opera-
tion admirable even in those portions of the limb
which are conical, and the free opening which is left
in the most depending part of the stump for the
passage of the ligatures and the evacuation of blood
and pus. The integuments being brought together
also from side to side, a fold is formed anteriorly
which obviates, in a great measure, the danger of a
protrusion of the spine of the tibia."
To this plan I beg leave to make a very slight,
but, which every operator will find, very decided im-
provement :
During my connection with the C. L. Army, the
necessity in which I often found myself of perform-
ing rapid amputations under the enemy's fires, made
me adopt a line of incision much like the above, but
which I consider far preferable inasmuch as it com-
bines all the advantages claimed by Prof. Hamilton's
plan, with a greater facility of execution.
My method consists in the primitive circular line
of incision to which a two-inch incision is added at
right angles, precisely in the same place where Dr.
Hamilton places his curves. A. Varona.
asphyxiated, with the funis encircling the neck
three times.
The child was resuscitated after eight or ten min-
utes. The mother made a good recovery and the
child is doing well. J. F. Oaks, M. D.
Asphyxia in Breech Presentation. — Mary E. Ellis,
aged 2 1 ; primipara. Admitted to the Brooklyn
Homoeopathic Maternitie March 19th, 1873.
On the 27th of the same month, while going
down the steps in the rear of the house, the patient
fell and struck on the small of the back, which caused
much pain in sacral region and left side.
These pains continued until Sunday evening,
March 30th (9.30 P. M.), when she experienced a
few smart pains, followed by rupture of membranes.
On examination found the breech presenting in
first position.
During an efficient pain at 3. 10 A. M. the podalic
extremity of the child swept over the perineum, and
immediately all expulsive efforts ceased.
Perceiving the danger to the child of asphyxia, I
immediately went in search of the shoulder, which
I reached after making slight traction, delivering
the left, then the right arm; and, without losing
any time, delivered the head of the child by flexing
the body on the abdomen of the mother, and with
my right index finger inserted into the mouth of
the child ; the nurse, during this time, keeping her
.hand on the uterus and making pressure upon it.
I delivered the head by flexion.
Although the child was promptly delivered it was
Ligature of the Femoral Artery — Secondary
Ha>7norrhage — A Loose Ligature Arrests the Flow
— Recovery. — On the 13th of March, Mr. T. Pulido
was brought into my ward with a punctured wound
in the middle third of the left thigh which penetrated
the femoral artery. I cut upon the wound and ap-
plied two ligatures, one on each side of the puncture.
On the following day, March 14th, at 8 P. M.,
secondary haemorrhage occurred, and, in spite of all
the efforts made to control it, continued, with short
intermissions, for twelve hours. March 15th, at 8 A.
M., I exposed the vessel anew, and finding that it
was pulsating with unusual violence against the car-
diac ligature, I passed a thread around it and tied it
loosely two inches above the said cardiac ligature, in
such a manner as to diminish the force of the cur-
rent without completely obliterating it. In a few
minutes all bleeding ceased.
March 23d, the distal ligature came off. March
25 th, the cardiac ligature followed. March 30th, the
loose ligature came away. April 7th, the patient
left the Hospital in perfect health. A. Varona.
Phlegmasia Alba Dolens. — On the 12th of De-
cember, 1872, I was called to see Mrs. J., aged 35,
who, twenty-four hours previously, had given birth
to her fifth child. Hitherto she had always enjoyed
excellent health, and her children were all hearty
and well.
She complained of intense pain in the right leg,
which was immensely swollen from the thigh down-
ward. The child was puny, and as the mother
was unable to nurse it, as there was no appearance
of any secretion of milk in the mammae, it survived
only forty-eight hours.
The nurse had endeavored to draw milk from the
breast with the breast-pump, according to my direc-
tions, but as her efforts were fruitless I abandoned
all further attempts. The patient suffered from
high fever and occasional chills, and I prescribed
Aconite and Arsenicum, and ordered the limb to
be covered with compresses wet with a solution of
Hamamelis.
Dec. 13th. — Pulse more regular and fever less
intense. The limb swollen considerably larger and
more painful. Prescribed Aurum Muriaticum, and
Carbolic Acid dressings to be substituted for the
Hamamelis.
Dec. 14th. — Slept two hours during the night
and feels much better. The Carbolic Acid had
given her great relief.
I continued the same treatment and ordered beef-
tea to be given freely and milk punch occasionally.
During the second week a series of small abscesses
formed along the entire length of the limb. She
made a speedy recovery, and within a month could
partially bear her weight upon the affected limb.
The left limb is more frequently attacked than
the right one. This has been variously explained ;
some authors attribute it to the position maintained
by the body during labor, and others to be depend-
ent upon the amount of the hemorrhage. It may
be possible that the different anatomical distribution
132
The Medical Union.
of the spermatic veins may account for the greater
frequency of the affection on the left side, as the
left vein is less direct than the right in its course to
the vena cava.
Hamilton Rickaby, M. D.
A Remarkable Case of Enlargement of the Cervix
Uteri during Pregnancy . — Mrs. was the mother
of one child now four years old. She became preg-
nant a second time, when immediately the cervix
uteri began to enlarge. Each month it increased
both in length and thickness, except at its junction
with the womb. During the fourth month she
aborted, but within three months she was enciente
again for the third time. This peculiar condition
of the cervix again appeared and continued increas-
ing each month, to the full term of pregnancy. At
this time the cervix was about six or seven inches in
length, and three inches in diameter at its lower
extremity. At its uterine junction it was no larger
than in the normal condition, thus giving a pear-
shaped or pedunculated appearance to the mass.
The finger could be passed with ease through the
canal, which was directly through the centre, till it
touched the head of the child through the mem-
branes. During the day, while standing, this im-
mense cervix protruded through the vulva and hung
out about three inches — so far, that on first seeing
it I at once supposed it to be a case of procedentia
uteri of the third degree. On lying down at night
it would diminish in size and disappear within the
vagina.
When at its full size it presented all the appear-
ance of the ordinary cervix, except that it was mag-
nified in its proportions and seemed to be hypertro-
phied in all its structures. It was more yielding
in its texture than the normal cervix ; pressure upon
it appearing to diminish its size somewhat, and sug-
gesting, from the spongy feel, an engorged or vari-
cose condition.
As soon as labor began, this immense cervix
rapidly diminished in size till it was entirely oblit-
erated by the advancing head of the child ; and
after the labor was terminated the cervix was found
to be perfectly normal in all respects, and has
remained so ever since.
J. Robie Wood, M. D.
Effect of Vegetable Perfumes on Health.
— An Italian professor has made some agreeable
medical researches, resulting in the discovery that
vegetable perfumes exercise a positively healthful
influence in the atmosphere, converting its oxygen
into ozone, and thus increasing its oxydizing influence.
The essences found to develop the largest quantity
of ozone are those of cherry, laurel, cloves, lavender,
mint, juniper, lemons, fennel and bergamot ; those
that give it in smaller quantity are anise, nutmeg and
thyme. The flowers of the narcissus, hyacinth,
mignonette, heliotrope and lily of the valley, de-
velop ozone in closed vessels. Flowers destitute of
perfume do not develop it, and those which have
but slight perfume develop it in small quantities.
Reasoning from these facts, he says, the inhabitants
of marshy districts should surround their houses
with beds of the most odorous flowers, on account
of the powerful oxydizing influence of ozone devel-
oped by them.
Ovariotomy followed by Twin Preg-
nancy.— Dr. Oilier, of Orleans, relates a remark-
able case of a woman, who had been four times
pregnant, three times tapped for ovarian dropsy, ^
and afterwards subjected to ovariotomy ; the tumor f
had no adhesions. Three months after the opera-
tion, this woman became pregnant, and at full term
was delivered of fine twins.
Treatment of Prolapsus Uteri without
Mechanical Agency.— Dr. Andreaf recommends,
as having been successful in several cases of prolap-
sus uteri, the local application of a tincture of iodine.
He was induced to try this method by observing that
in certain cases iodine, locally applied, had an effect
upon the ligaments of the uterus, causing them to
pass from a relaxed into a normally firm state. His
directions for carrying out the treatment are chiefly
the following : Before beginning the treatment, all
other diseases of the uterus should, as far as
possible, be removed, because the iodine, acting for
instance on ulcerated surfaces, is apt to induce
serious inflammation. Previous to the operation,
the uterus should be replaced, and the patient should
continuously retain the horizontal position till after
at least two applications. At first only a small
quantity, and a dilute solution, made of equal parts
of the tincture and alcohol, should be used, and the
dose and strength should be gradually increased on
successive applications. The solution should be
painted on to the arch of the vagina, around the
neck of the uterus, and not less than three days
should elapse between the successive operations.
During the period of treatment, the cold vaginal
douche (700 F.) should be used several times daily,
and continued for some time after the local applica-
tion has ceased. The bowels should be kept free
throughout the period of treatment.
The Placenta in Gastrotomy. — An interest-
ing discussion, on the proper management of the
placenta in cases in which gastrotomy is performed
in extra-uterine fcetation, recently took place at the
Obstetrical Society. Dr. Meadows narrated a case
of gastrotomy for extra-uterine fcetation. An at-
tempt was made to remove the placenta ; this was
followed by an uncontrollable hemorrhage which
ultimately proved fatal. Dr. Meadows laid it down
as a rule in all future operations of this kind, that
the placenta should be left untouched, to come away
with the discharge. In' the discussion which fol-
lowed, Dr. Barnes stated that Dr. Meadows was
mistaken in supposing that this suggestion was new,
and in a subsequent note he went into the literature
of the subject. He stated that
1. A perusal and comparison of recorded cases of
gastrotomy in extra-uterine gestation could not fail
to convince the reader that the attempt to remove
the placenta had proved disastrous, while leaving it
alone had been followed by fair success.
2. Most of the recent operators, acting on the
conclusion thus drawn, had taken care not to touch
the placenta. The latter statement is fully borne
out by the recorded cases which Dr. Barnes had
collected ; and it may be considered as an estab-
lished fact that in primary gastrotomy, in which the
operation is performed in the hope of saving the
foetus, the placenta is bound down to the parts to
which it is attached, by such intimate and firm A
adhesions, that no attempt at its removal is justifi- V
able.
The Medical tlniort.
133
The Medical Union
A MONTHLY JOURNAL
Of Medicine, Surgery, aizd the Collateral Sciences.
Editors :
EGBERT GUERNSEY, M.D. CHARLES E. BLUMENTHAL, M.D.LL.D.
JOHN C. MINOR, M.D. ALBERT E. SUMNER, M.D.
H. M. PAINE, M.D.
Published on the First of each Month, by
C. T. HURLBURT, 898 Broadway, New York.
NEW YORK, JUNE, 1873.
" A regtdar medical education furnishes the only presumptive
evidence of professional abilities and acquirements, and ought to be
the only acknowledged right of an individual to the exercise and
honors of his profession." Code of Medical Ethics, Amer. Med.
Ass., Art. iv, Sec. i.
)
ALLOPATHY VS. HOMCEOPATHY.
The Board of Trial of the Massachusetts Medical
Society which recently tried certain members of the
society for practicing homoeopathy, on the ground
that such practice violates their right to member-
ship, have just rendered a decision. Here it is:
"The parties having been fully heard, and evi-
dence and arguments on each side fully considered,
we do find and determine that said charges and
specifications are all fully proved against each of the
said accused persons, and they are severally guilty
of the charges aforesaid — guilty of conduct unbecom-
ing and unworthy an honorable physician by prac-
ticing homoeopathy — and we, therefore, adjudge and
determine that said William Bushnell, Milton Fuller,
H. L. H. Hoffendahl, George Russell, J. T. Talbot,
Davis Thayer, Benjamin A. West, be therefore ex-
pelled from their membership of the Massachusetts
Medical Society, and report this our determination
to the Massachusetts Medical Society at its annual
meeting for such action thereupon as to the society
may seem fit.
"Jeremiah Spofford, Augustus Torrey, George
Hayward, Frederick Winsom, a majority of the
Board of Trial."
We can only say, if Allopathy can stand this
sort of thing we think Homoeopathy can, and this
seems to be the opinion of the New York Evening
Post, which we append below :
"Among our Saturday dispatches was one from
Boston containing the decision of a Board of Trial
of the Massachusetts Medical Society in the case of
several physicians who were charged with having
violated their right of membership. The Board re-
commend the summary expulsion of seven members
for ' conduct unbecoming and unworthy an honora-
ble physician, by practicing homoeopathy.' We do
not know what the rules of the Massachusetts Medi-
cal Society are — and that is of little consequence to
the question which this decision seems to open.
If the Society's constitution excludes homceopathists,
that is its own affair only, and we cannot complain
if it enforces its rules.
"But the question, What constitutes a worthy or
an honorable physician ? does concern the public,
who will be apt to ask by what rule the Board
of Trial of this society assume to dictate the man-
ner in which diseases may be ' honorably ' treated.
If this judgment is to be law in medicine, why
may not the lines be drawn still straighter, de-
manding a return to the old practice of emetics
and starvation ? Why not banish cold water, air,
and exercise for patients? May we also suggest
that it would be well to have a standard measure
for doses of medicine, for fear that tender-hearted
doctors may treat their patients too homceopathi-
cally even in allopathic medicines? While we are
about it, let us fix the standard of ' honorable '
orthodoxy in dress so acutely that no wretch of a
physician who has a mind or a theory of his own can
endanger the profession for the sake of his patient.
Let us establish the fact beyond doubt that a man
who may be cured by an heretical or ' dishonorable '
treatment is not cured, although he may live to the
age of Methuselah, and that the man who dies
under the schedule treatment, by weight and meas-
ure, still lives in spite of natural appearances."
The above, together with the following, from an
editorial in the New York Daily Times, show the
opinions of leading public journals, and pretty accu-
rately represent public sentiment in reference to this
august Boston tribunal and its star-chamber pro-
ceedings :
" We have, of course, no opinion to offer in regard
to the merits of homoeopathy, or of that school of
medicine which its adherents say is not all allopathy,
but which is certainly not homoeopathy. That is a
matter for every physician, and every person need-
ing a physician, to settle for himself. But the man-
ner in which the case to which we have referred has
so far been conducted, calls for comment on account
of the singular narrow-mindedness and bold injustice
by which it has been marked. Considering that the
prosecutors and judges belong to one of the most
highly educated and honorable bodies of professional
men, and considering, moreover, that they were en-
gaged in trying the very delicate question of the
fitness of certain of their professional comrades to
associate with them, it would be natural to expect
that their proceedings would have been direct, open,
and scrupulously guarded against any trespass upon
the rights of the accused.
" Instead of this, we find the Board of Trial begin-
ning the final hearing with closed doors, refusing to
allow friends of the accused to be present, refusing
to admit the reporters of the press, refusing legal
counsel in a case which involved rights both of char-
acter and reputation, refusing to choose a phono-
graphic reporter after the record of the Secretary
was impeached, refusing to allow the accused a
reporter, refusing a premptory challenge of the
members of the Board of Trial, and finally, refusing
to hear any challenge for cause. It does not seem
to have occurred to the physicians who constituted
the Board, that such conduct on their part would
deprive their verdict of all respect from intelligent
persons in or out of their society, and, when known,
as it was inevitable that it must be known, would
awaken the liveliest public sympathy with the medi-
134
The Medical Union.
cal ' heretics ' whom they were seeking to cast
out.
"We do not propose to go over in detail the
evidence or arguments in the case, as far as they
have been published. The defendants undertook
to show, and so far as we can judge, did show, that
there was nothing in the legally-defined purposes of
the Massachusetts Medical Society which made the
practice of homoeopathy inconsistent with member-
ship. They showed that they had been members
of the society for periods varying from sixteen to
thirty years ; that they had fulfilled all the require-
ments of the constitution, and that one of their
number was known to be an officer of the Homoeo-
pathic Society at the time he was admitted to the
Massachusetts Society. The published defense of
the accused persons, as delivered on the trial, is
candid, temperate, and courteous toward their prose-
cutors ; it is also exceedingly vigorous and logical,
and betrays in all respects the air of men of culti-
vated minds and assured position. The Board of
Trial seem to have been engaged in a work of
doubtful legality, which, if legal, was exceedingly
ill-judged, and which has been carried on in the
most arbitrary and unjustifiable manner.
"It is to be hoped that the society itself will
reject the suggestions of the Board ' of Trial. It
can make little difference to the homoeopathic physi-
cians of Boston whether they are retained or ex-
pelled by the Massachusetts Society. Their merits
as physicians, or the public opinion of their merits,
will not be affected one way or the other. But the
majority in the society cannot afford to sanction a
procedure which, affecting to determine a question
of honorable conduct, has been marked by so many
features of unfairness and abuse of power. If the
society consult their patrons, they will find that it
is no longer the accused, but the accusers and the
judges, who are on trial before intelligent people."
BROOKLYN HOMOEOPATHIC HOSPITAL.
The success of this institution is now fully assured,
and the trustees are more than pleased with the re-
sult of the first three months' work. There have
been admitted to the hospital forty-two patients, and
twenty-one are at present in the building. Twelve
surgical operations have been successfully performed,
and a number are waiting for surgical aid, among
them, a case of ovarian tumor. As yet, there has
been no loss of life. In a few days a new medical
ward will be thrown open to the public. It will be
known as the Bishop's Ward, in honor of Bishop Lit-
tlejohn, of the Long Island Diocese, who has taken
quite an active interest in the hospital from its in-
ception, and who presided at the formal opening.
The ward will accommodate fifteen beds, and has a
separate bath room and nurse room. It will be used
as the male medical ward. The male patients will
now have the first floor, and the female patients the
second. In addition to this improvement, four
handsomely furnished private wards have been pro-
vided for pay-patients. The grounds have been
laid out in the most approved manner, and the ap-
pearance of the property is completely changed.
In the mean time, the State has ordered an annual
appropriation of $4,000 for the support of the
hospital, and the income from patients will not fall A
short of $4,000 more, so that in every way the
trustees feel that they have met with entire and
comDlete success.
HOSPITALS.
There are thousands of children dying every
summer for lack of fresh air and healthy food.
There are thousands of mothers and fathers, with
warm hearts and full purses, who would gladly save
these little ones if they only knew how. The suc-
cess of the Times excursions last summer showed
that there would be no lack of means if the way
were only pointed out, and the management placed
in competent hands. These excursions did a vast
amount of good, and were worth to the poor little
children — many of whom thus obtained their first
glimpse of the country — in health and happiness,
ten times the amount they cost. We have no doubt
that every contributor to this fund was amply re-
paid in the real good accomplished.
Here is work for ladies to do ; not only in New
York, but in all our large cities, where the poor are
crowded in close quarters. Let some active, ener-
getic lady take the lead and set the ball rolling ;
some one, perhaps, who feels she owes a debt of
gratitude for the preservation of her own little ones,
or whose sympathies have been awakened for all
little children as she placed the dead forms of her
own babes away from her sight but not from her
memory, under the sweet spring flowers. Let a
little of the money she would have spent upon
them go to bring gladness to other hearts and
life to those who, but for her help, must pass
away ere they have scarcely tasted the cup of life.
The way is simple and easy. In every church,
in every social circle, gather together those who
would like to aid in a cause like this ; hire a little
cottage by the sea-shore or among the hills, any-
where in a cool, healthy location, where God's fresh
air can reach them untainted, in all its purity and
vitalizing power ; furnish it cheaply and place in it
some kind, motherly woman as matron, or a sister
from some of the religious institutions. Now gather
together the poor and the outcast, those shut up in
crowded rooms and dying for want of fresh air and
a little healthy food, and see how the color will
come back to their pale cheeks and life to their
wasted forms. Keep them here during the hot
months of summer, and send them back in the fall
with a stock of health which will give them a fair
start on their voyage of life. And some time dur-
ing the hot summer days, when the air feels like a
The Medical Union.
135
furnace in the great city, and you are tired with
the whirl of Newport and Saratoga, go down
among them and see if any opera was ever so sweet
as the music of their laugh, or any picture so beau-
tiful as their sweet, bright faces, flushed with
health and happiness.
This is missionary work, real hospital work, re-
quiring no costly buildings, no complex machinery,
but simply a little money, a little labor — an outlay
which will be returned ten-fold in the happiness of
feeding God's little ones, and in rescuing them
from death.
Who will start the first hospital ? What phy-
sician's wife will thus become a missionary for
good ? What kind-hearted woman, with the love
of humanity in her soul and the words of the Great
Physician in her ears, " Inasmuch as ye have done
it to the least of my little ones, ye have done it
unto me," will put her hand to the work and see
that it is accomplished ?
SANITARY REFORM IN THE COOPER UNION.
The worst ventilated public room in New York is,
unquestionably, the Reading-room of the Cooper
Union. The atmosphere in this place is loaded
with effete animal matter and poisonous exhalations
to a greater and more deadly extent than exists in
any prison in the city. As the visitor opens the
door upon entering, he is saluted with an outward
rush of foul air that is moist, warm, and reeking
with that peculiar odor that belongs to overcrowded
rooms in tenement houses. After a few minutes
sojourn in the room the sense of smell becomes less
acute and the vile odor is no longer noticed. It
still exists, but the faculties soon become benumbed
by the effects of the poisoned air, so that they lose
their natural acuteness. The vast room is crowded
with readers, but a more sleepy set were never seen.
The atmosphere is heavy with carbonic acid gas,
and under its influence all become more or less
drowsy; many will be found actually asleep and
nodding in their chairs. It is not a natural sleep
from weariness, but the direct action of a poisonous
gas. Were these sleeping men drunk from liquor,
their sanitary condition would be no worse than it is
when drunk from the anaesthetic effects of a deadly
gas. On looking at those who habitually frequent
the Reading-room, the deleterious effects of the
air will be found expressed legibly in the sickly, wan
and unhealthy countenances of the readers. The
very gas-lights burn with a dim and feeble light in
this atmosphere. As a hot-bed for the origin and
spread of typhoid fever and zymotic diseases in
general, it has no superior in New York, and we
-^seriously question whether the mental benefit of the
Reading-room is not more than outweighed by its
injurious effect on the health of those who frequent
it. The new Board of Health should not omit this
place from their inspections, for it is not only the
worst public place in the city, considered from a
sanitary point, but there is absolutely no excuse for
its vile condition. Its lofty position, having un-
limited avenues for the accession of light, and pure,
healthful air, is unsurpassed, and we therefore do
not hesitate to condemn its present condition as a
crime against the public health. During the
summer time the windows will probably be opened
so as to admit of proper ventilation, but unless
some means are adopted for a proper ventilation
during the winter months, it would be better to
close the Reading-room during the cold weather.
MEDICAL ADVERTISING.
It is Derogatory to the Dignity of the Profession to
Resort to Public Advertisements, or Private Cards, or Hand-
bills, Inviting the Attention of Individuals Affected with
Particular Diseases — Publicly Offering A dvice and Medicine
to the Poor, Gratis, or Promising Radical Cures ; or to Pub-
lish Cases and Operations in the Daily Prints, or suffer
s'uch Publications to be made ; to Invite Laymen to be pres-
ent at Operations; to Boast of Cures and Remedies; to
Adduce Certificates of Skill and Success or to Perform
any other Similar Acts. These are the Ordinary Practices
of Empirics, and are Highly Reprehensible in a Regular
Physician. — Code of Medical Ethics, A merican Medical Association :
Of the Duties of Physicians to each other, and to the
Profession at Large. — Article i, Section 3.
HISTORY OF ANESTHETICS.
On Wednesday evening, May 21, at eight o'clock, a series
of interesting discourses " On the History and Chemistry of
Anaesthetics" will be delivered in Steinway Hall by Dr. J.
Marion Sims and Professor R. Ogden Doremus, respectively.
Experiments illustrative of the practical application of anaes-
thetics in surgery, will be performed by Professor Frank H.
Hamilton. An address will also be delivered on the occasion
by the Rev. Henry Ward Beecher. The exercises will be
presided over by Mayor Havemeyer, at whose request,
joined with that of the numerous scholarly and prominent
men of the city, the exercises are to take place. Mr. Charles
Walter will play appropriate organ airs, and the evening will
be made one of unprecedented interest and instructiveness.
— New York Herald
This interesting event took place as announced
and afforded great amusement to a large audience ;
but we cannot help thinking how much was left un-
done that would have rendered the entertainment
still more attractive. To be sure, the music was
very fine, and the manner in which Mr. Walter
rendered the appropriate airs "Rock me to sleep,
mother," and "Blow your horn, Gabriel," brought
tears to the eyes of each medical man in the vast
assemblage; but if the distinguished Stephen Smith,
M. D., could have been induced to give a tight-
rope performance, or A. Flint, Sen., induced to
render the " Star Spangled Banner," many persons
in the audience would have derived much more en-
joyment from the evening's entertainment. The
Rev. H. W. B. was evidently so much pleased by
what he saw and heard that for the first time in his
life he failed to find words to express his admiration
of the distinguished men by whom he was sur-
rounded, and he simply dismissed them with his
136
The Medical Union.
benediction. We congratulate the gentlemen upon
the success of the performance, and hope they will
profit by our suggestions if they try it again.
It may seem quite unnecessary for us to call atten-
tion to this.
OPHTHALMOSCOPIC INVESTIGATIONS.
This is an age of progress. The world cherishes
the fact and proclaims it from the pulpit, the forum,
and the press. The thought of progress and ad-
vancement is captivating, and progressive things are
hailed with glad delight. Further, the people de-
mand that everything should coincide with the spirit
of progress. The minister, to be popular, must be
progressive and shape his doctrine to harmonize
with the teachings of science as revealed to-day.
The politician, to be successful, must support
heartily all measures of progress and reform.
And the press of to-day reaps its most golden
harvests in according with the pervading spirit of the
times, by advocating progressive measures and de-
manding reform.
The laity, recognizing the wonderful advancement
made in philosophy, astronomy, geology, and in
physical science, queries often if there has been as
great progress in the department of medicine.
We are continually forsaking the traditions of our
fathers in medicine, and with the aid of the micro-
scope are recognizing functions and abnormalities
which were hitherto only surmised or unknown ;
and with our improved means of diagnosis we are
able to localize diseases now, where, a decade since,
only ingenious guesses could be made.
Perhaps in no department of medicine has there
been greater advancement made in the knowledge
of organs, their functions and their diseases, than
in that of nervous diseases.
Much of it is due to the revelations of the
ophthalmoscope, and for purposes of diagnosis in
diseases of the brain, it is of equal value to the
stethoscope in diseases of the thoracic organs.
Tubercular meningitis is dreaded by every
physician. When once recognized it is deemed in-
curable, and the practitioner reproaches himself and
the science of medicine that he is powerless in meet-
ing these cases. According to Albutt, in a recent
work on the ophthalmoscope, this disease can be
recognized and cured in its early stages.
He says : "I think I am in a position to say that
the mirror enables us to learn something more con-
cerning the clinical history of tubercular meningitis
than we know already, and that this additional
knowledge will bring about some change in our
views and opinions concerning the frequency and
the curability of this formidable disease.
"The anterior subarachnoid space, with the syl-
vian fissure, is a district which is especially one of
the districts of tubercular meningitis, and the
chiasma seldom escapes.
"In their backward course from the chiasma up
to the tubercular quadrigemina, the tracts arc closely
invested by the highly vascular pia mater, and they
are, in great measure, dependent upon it for their
nutrition. Inflammation of the membranes upon
the tracts, chiasma or optic nerves, therefore,
not only creeps up to the eye and presents its
characteristic cell proliferation, but it also cuts off
nutriment from the nervules This compound mode
of change I have several times verified with the
microscope, and have seen the gross connection-
tissue of neuritis enclosing, not crushed, nerve-
filaments, but empty or half-empty spaces from
which the filaments were withering or had withered
away.
" The important question for us to decide is,
whether we have any means of detecting with cer-
tainty the presence of meningitis in those slighter
cases where we can now only guess at it, or can
scarcely even guess; and in which cases we need
not expect to find a large per centage of mortality.
It is here, I think, that the ophthalmoscope comes
to our assistance and gives us the same kind of
help in detecting incipient or slight degrees of tuber-
cular meningitis, that the stethoscope gives us in
detecting those incipient or slight degrees of ulcera-
tive change in the lungs, which, without it, are be-
yond certain diagnosis. When a patient is seized
with vomiting, headache, convulsions, and other
symptoms of much meningitis, and when at the
same time, on examination with the ophthalmoscope,
I find congestion of the optic disk and retinal ves-
sels, which is frequently the case, then I have no
hesitation in saying that the patient is suffering from
meningitis at the base of the brain ; and the autopsy
proves the diagnosis to be correct. Suppose, how-
ever, that a child is liable to occasional vomiting
of a purposeless kind, and attended with but little
nausea ; suppose him to be liable to an evening
fever, and to be rather restless, or sometimes very
restless at nights ; suppose, moreover, that he com-
plains of pain in the head from time to time, of a
kind which drives him for a few hours only from his
companions and his games, or, perhaps, for a day
or two ; suppose, again, that his temper changes,
and from being a good child he becomes irritable
or positively mischievous; while at the same time
his memory does not develop, and he is quite unable
to fix his attention upon his school work ; suppose,
farther, that he suffers from spasmodic movements
during his sleep, or even from full convulsions, and
that the child nevertheless recovers from this
state, and returns either to full health or to health
of body with more or less injured mental faculties —
should we call such a case meningitis ?
" Now, I have had many such cases under my
care, and I have records of many in which the oph-
thalmoscopic appearances were noted throughout,
and in which I found those same signs in very well-
marked degrees, which I have also described as oc-
curring in undoubted cases of meningitis, proved by
autopsy. Is it not probable that in these cases we
have also meningitis — a meningitis less severe than
that which proves fatal, but meningitis, nevertheless !
During the last few years I have given a great deal
of time and care to the investigations of the state of
the eye in meningitis, and I have been long con-
vinced that the tubercular form as a disease of fk
children, is more common and less uniformly fatal
than is generally supposed]!
The Medical Union.
m
Reviews of Boohs.
The Science and Art of Surgery"; embracing
Minor and Operative Surgery ; compiled from
Standard Allopathic authorities and adapted to
Homoeopathic Therapeutics. By E. C. Frank-
lin, M. D. Vol. II. , St. Louis, 1873.
This volume completes Dr. Franklin's work on sur-
gery, which is now before the profession as a guide to
active practitioners, and as a text book for students.
The book is printed on a poor quality of paper ;
the illustrations are of an inferior character, and at
a superficial glance, there is an unfavorable impres-
sion produced by the handiwork of the printer.
Of the author's work we can speak with more
satisfaction. Dr. Franklin is well known as a good
surgeon, skillful and successful as an operator, and
having a large experience from which to draw cor-
rect inferences with reference to treatment. As
surgeon, professor, and author, he has always been
characterized by throughness, and in the work be-
fore us he fully sustains his reputation. Dr. Frank-
lin has approached the task of writing a work on
surgery in the right spirit. The operative part of
surgery, and the principles of pathology on which
it is founded, are the same in all schools. There
can be no such thing as " Homoeopathic Surgery."
The term contradicts itself. But the application of
homoeopathic practice to surgical diseases and con-
ditions has been proved over and Over again to be
of singular efficacy, and homoeopathic surgeons are
now demonstrating every day the superiority of the
homoeopathic practice as compared with the results
obtained by the surgeons of the old school. Dr.
Franklin, very wisely, selects from our opponents
the very basis of operations. The details of diag-
nosisy pathology and operative treatment are taken,
with few exceptions, from the latest and best author-
ities in the old school. His selections are evidently
the result of a wide range of surgical reading, and
show a through appreciation of the subjects, as well
as a practical acquaintance with clinical cases.
In the application of homoeopathy to the treat-
ment of surgical conditions and diseases, Dr.
Franklin's work will be of great value as a guide to
physicians in ordinary practice. The author here,
as in other parts of the work, does not confine him-
self to his own experience, but quotes from others
who have been successful with homoeopathic reme-
dies. We give a few extracts illustrating the appli-
cation of homoeopathy to surgery. Speaking of Non-
Union and False Joints Dr. Franklin says : "I
have never heard of, and certainly have never ex-
perienced in the various cases of practice I have
treated, both in hospital and civil practice, this mal-
condition where sy?nphetu?n was properly adminis-
tered, and I do believe that non-union of bones,
except under the most adverse circumstances, will
never occur under the judicious use of this remedy.
Professor Morgan, of Philadelphia, reports a num-
ber of cases of delayed union in bones to have been
speedily corrected by Calcarea phos. from the third
to the sixth potency."
In the treatment of Synovitis , the author gives
the proper indications for the use of the ordinary
Remedies, but his own clinical experience has been
most satisfactory with Propylamin and Sulphuric
acid. Of the first, he says : " This remedy is pre-
pared by distillation from herring brine, and in 250
cases of acute rheumatism treated by Dr. Amena-
rius, of St. Petersburg, the pain and fever disap-
peared in every case the day after its administra-
tion. My experience in the use of this remedy is
limited, but in all cases of acute rheumatic fever,
in which I gave it alone as soon as called in, the pa-
tients were promptly relieved in thirty-six hours,
and convalesced in a few days without any untoward
symptoms. The Propylamin is found in two forms ;
the liquid, a distillation from the herring brine, is
colorless, transparent, and possesses the fish brine
odor ; the muriate is in the form of fine crystals
very soluble in water, one grain of which is about
equal to one drop of the liquid. Dose: two or three
drops in a glassful of water, and taken every two
hours, for an adult. "
" In certain seasons, in my hands, the greatest
benefit has arisen from the use of mineral acids, and
especially Sulphuric. The number of cases under
treatment have not been sufficiently large to arrive
at positive conclusions, as I do not feel justified in
neglecting local treatment, but in all the cases that
fell under my observation last spring (1871), every
one was completely cured by this internal agent
alone, after the accute symptoms had been subdued
by Aconite, and I believe a careful trial of this rem-
edy will satisfy any one of its great curative value
in rheumatic fever."
The larger part of this volume is devoted to
the consideration of Fractures, Dislocations and
Operative Surgery. The two former subjects oc-
cupy 242 pages profusely illustrated, and are models
of careful research and judicious treatment. No
other work on General Surgery contains so complete
and exhaustive a consideration of these important
topics, We cannot say as much for the part de-
voted to Operative Surgery, in part because Dr.
Franklin's handling of the subject of dislocations
and fractures led us to expect an equal excellence
in this department, which we do not find, and in
part because the space allotted to the subject (334
pages) is not sufficient to allow of anything like
exhaustive treatment. Dr. Franklin leans very prop-
erly toward those operations that are thoroughly
proven and efficient, but sometimes we think that he
carries this conservatism a little too far. For in-
stance, in the radical cure of Hydrocele, the author
gives but one method, viz. : withdrawing the liquid
from the cavity and the injection of Iodine. No men-
tion is made of the radical cure by snipping out a
piece of the tunica vaginalis, or by the operation of
electrolysis, although both are as effective as the
treatment by injection. In the more important
operations there is more thorough work done, and
our adverse criticism app>tes in general only to the
smaller operations, which, we think, are sometimes
disposed of too hastily. Whenever Dr. Franklin
quotes from his own experience, whether in the use
of remedies or of operative procedures, there is
always something that deserves attention. However
old fashioned he may be in theory, his practice
shows him to be brilliant in practice and courageous
in adopting new measures that promise a success-
ful result. We quote from (p. 731) one of the
author's cases, the first of its kind ever performed,
in evidence of our opinion of his daring and
success. The case was one of Ovarian Tumor
cured by Electrolysis. * * "I felt sure
that the case was an unilocular cyst of the left
138
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ovary, and concluded to try the effects of the
electro-galvanic current, upon the same principle as
my friend, Prof. Danforth, of Chicago, had employ-
ed it in the case of a large hydrocele, with the most
triumphant success. Having appointed a time for
the operation, and procuring three gold needles to
be used in the process, and a twenty-cell battery, I
approached the operation, not without some timid-
ity, as I was traveling over new ground, and feared
the uncertainty lying before me. The more I re-
flected over the principles involved in the curative
process, the more hopeful I became as to the result.
Preparing the patient for the operation, adjusting
the battery, and applying over the tumor, which
was the size of a large cocoanut, a heavy steel ring,
forcibly held downward by an assistant, I plunged
into the sac, one at a time, the three gold needles
prepared for the purpose. Now placing the positive
electrode upon the back, and the negative in con-
tact with the needles, the current was kept up for
nine minutes through the sac. The patient only
complained of pain and smarting in the back. The
battery was applied as before, and continued until
the skin surrounding the needles showed evidences
of cauterization when they were withdrawn. The
last application of the galvanic current was con-
tinued sixteen minutes. Upon examination of the
tumor, its elasticity was gone, and in place of the
fluctuation so plainly felt before, there appeared a
'boggy,' doughy mass, very unlike the character-
istics previously experienced. There was but slight
pain or constitutional disturbance following this
operation, and in a week my patient was walking
about ; in three weeks she went home, the tumor
having so far disappeared that it seemed no larger
than a pullet's egg. Since then, she has written
me that she is well and never felt better in her life."
With this remarkable and suggestive case we
must close our notice of the book. It is a good
work; beyond comparison, the best for homoeopathic
practitioners. It has some defects, which are mere
omissions of some good things rather than commis-
sions of bad, but we find so much to commend in
Dr. Franklin's work, that we can even overlook the
printer's work, and advise our readers to place these
volumes on their book-shelves for reference in sur-
gical cases.
Aural Catarrh and Curable Deafness. By
Peter Allen, M. D., Fellow of the Royal
College of Surgeons, Edinburgh ; Member of the
Royal College of Surgeons, England ;. Aural Sur-
geon to, and Lecturer on, Aural Surgery at St.
Mary's Hospital, etc., etc. Wm. Wood & Co.
1872.
This book does not pretend to be an exhaustive
treatise upon the subject of aural diseases, but gives
a short and systematic expose of a class which are
most commonly met with in the routine of every-
day practice.
According to Von Troltsch, about one-third of all
people between the age of twenty to forty years,
suffer from some form of aural disease. In five-
sixths of these, the deafness is supposed to have
arisen from morbid conditions of the mucous mem-
brane lining the throat, nasal passages, and middle
ear.
As the author devotes himself exclusively to the
catarrhal diseases, he very appropriately designates
his book as lectures on "The Commonest Forms of
Deafness, and their Cure. " Like every good teacher,
Dr. Allen endeavors to simplify his subject, so that
it may be acceptable to the student ; and, in doing i
so, he has made his book a profitable one for the
general practitioner, who, among the multitude of
cares, and in the drive of business, has usually but
little time to devote to the perusal of lengthy treat-
ises upon special subjects.
He touches lightly the anatomy and physiology of
the ear, and only enters upon that which has a
direct relation to the subject under his consideration.
In the latter, he enters into a discussion on the phys-
iology of hearing amidst noises. It is a well-known
fact that in deafness resulting from some forms of
aural catarrh, the patient hears better or well, when
riding in a carriage or omnibus, amidst great noises
or loud rumbling, roaring sounds.
The immense improvement which sometimes oc-
curs in these instances has been variously explained.
Some writers have considered it imaginary on the
part of the patients. The author, after giving
several of the more prominent theories lately ad-
vanced, enters upon a physiological explanation of
it, as follows :
"Stretched membranes take up vibrations from
the air with great readiness. Now, when patients
are suffering from the effects of a catarrhal disorder
which has left the drum-head in a relaxed, flabby,
sunken, atrophied, thinned, or collapsed state, or in
fact, in any condition which has greatly reduced its
vibratility, we find that an improvement in their
hearing takes place whenever tension of the diseased
membrane can be accomplished. But, it will be asked,
how can the deaf person, while riding in a railway
carriage, or amidst a tumult of sounds and noises,
as before mentioned, have the state of the mem-
brane suddenly changed from relaxation to tension ?
The reply to this inquiry will, I am persuaded, fur-
nish the true explanation of this curious fact. The
tensor tympani, which alone tightens the membrane,
receives its nervous supply from the otic ganglion,
and from the motor root of the trigeminus, the third
or inferior maxillary branch of the fifth. Its con-
tractions are therefore, mostly, if not entirely invol-
untary movements, unlike in this respect, as we
have seen, to the stapedius. Politzer has, by irrita-
tion of the tri-ge minus within the cranium of a
vivisected dog, stimulated the tensor tympani to
action, and rendered the effect visible on the mem-
brana tympani. This muscle is excited by reflex
action, like the iris, which may be caused, either by
the expectation of a local sound, or by any actual
sonorous impression.
"As the optic nerve, spread out on the retina,
requires the stimulus of light to cause contraction
of the muscular fibres of the iris, so does the audi-
tory nerve need the stimulus of sound to put the
tensor tympani into action.
"Thus, a patient with a relaxed membrana tym-
pani has the tension of it effected by the very sounds
which confuse us. Increased tension of our healthy
drum-heads will prevent our reception of ordinary
conversational sounds, whereas, a relaxed drum-
head by thus becoming stretched and tense, is
rendered more like our own, and is then in a state
to receive and transfer sounds that were before in^
audible. Simultaneously, a change occurs in thv*
position of the ossicles — the whole chain is, as it
were, braced up, and due tension of the inner mem-
The Medical Union.
139
brane and pressure upon the fluid in the labyrinth
effected. The patient, previously deaf, thus hears
as well as, or better than, we do ourselves under the
^circumstances specified."
The writer devotes two chapters on the different
modes of examining and inflating the middle ear.
He commends Politzer's method very highly, and
justly pays high compliments to one of the foremost
aurists of Germany, to whom the world is indebted
for much of the recent advancement in the knowledge
of aural diseases, and the more scientific and effec-
tual methods of treatment adopted at the present
day.
He has made improvements on the bag devised
by Politzer, and he takes numerous occasions to re-
mind the reader of them by frequently speaking of
inflating the tympanic cavity by his modified Po-
litzer bag :
"The modification consists in the addition of a
valve, through which fresh air is drawn into the bag,
thus obviating the necessity of withdrawing it from
the nose after each compression. Also, by substi-
tuting a nasal pad which is pressed against the
opening into the nostrils, for the tube which he in-
serted into one of them. Mounted on a strong piece
of covered copper wire, are two air pads, which can
be so approximated or separated, as to stop up con-
veniently the nasal orifices. The metal serves as a
handle for the surgeon or patient. Through each
pad runs a hole, and these holes communicate with
two short bits of India-rubber tubing joining into a
single tube. Into this tube the pipe of the inflating
bag is inserted, and the apparatus is thus complete."
Although commending Politzer's method highly,
and using it almost universally, we should suppose
from the records of his cases, he emphatically re-
commends the frequent employment of the Eusta-
chian catheter.
He says : " Unhesitatingly, there is no other agent
in the treatment of very numerous cases of catarrhal
deafness upon which we may so confidently rely as
the catheter," which coincides with the sentiments of
the French and German aurists.
He prefers those made of silver to the hard rubber
ones generally used in Germany and in this country.
His description of the steps of the operation of
Eustachian catheterism is not so clear and concise
as that given by Kramer.
The remainder of the book is devoted to the dif-
ferent forms of diseases which are classified under
the title of Aural Catarrh.
He simplifies the classification of these, making
three divisions only, in the place of eight, given by
Von Troltsch. They are, simple aural catarrh,
which is again subdivided into the two forms, acute
and chronic ; purulent aural catarrh, also acute and
chronic; and, otorrhoea, aural polypi, etc., or the
results of purulent aural catarrh.
He handles this subject with much ease, and gives
in a light, flowing style, the main points treated of
in larger and more exhaustive works.
In the treatment of the chronic aural catarrh, he
decries the prevalent custom of injecting liquids into
the middle ear through the catheter, and recom-
mends the use of atmospheric air and vapors instead.
He denounces the treatment adopted on the conti-
Jent, saying, "it is, in his opinion, too violent in
haracter, and too abruptly entered upon." His
own experience " is opposed to the sudden and early
introduction of the catheter, either as being neces-
sary to diagnosis, or as a therapeutic agent." He
advises gentler and less disagreeable or painful
modes of opening the Eustachian tubes, and restor-
ing air to the drum cavity, and does not approve of
the sudden and forcible injection of fluids. He
agrees with Von Troltsch in his preference for vapors,
as he says in his experience, "with the exception
of iodine and acetic ether, the vapor of hot water —
i. e., simply steaming the cavity of the tympanum —
is the best"
The operation of "paracentesis" is strongly dis-
paraged in chronic catarrh. It has lately been much
resorted to by aurists in London, and also by a few
in Germany. But, in the author's experience, it is
often followed by severe reaction, entailing conspicu-
ously evil results. The author intersperses a few well-
marked cases to illustrate the treatment advocated.
According to the rapid results he effected in these,
extraordinary success must have crowned his efforts;
for rarely have I ever seen so speedy and permanent
cures made under the most skillful of prominent
aurists, either on the continent or in this country.
The book is a valuable addition to the department
of aural literature, and will fill a niche in the library
of the student and general practitioner, as a short,
clear, and concise treatise on the commonest forms
of deafness and their cure.
{Transactions of Societies,
AMERICAN INSTITUTE OF HOMEOPATHY.
This society, the oldest national medical asso-
ciation in the United States, commenced its Twenty-
sixth session, June 3d, in the hall of the Homoeopathic
College, Cleveland. The meeting, which was well
attended, was called to order by the President, Prof.
A. E. Small, when an eloquent address of welcome
was delivered by Prof. J. C. Sanders, of Cleveland.
"Wearied by your journeyings," he said, "and
worn by labors, responsibilities and anxieties you
have left behind, you come from states near and far
away. Ohio, vast, rich, mighty in peace and in
war, in greeting salutation unfurls over you her ban-
ner of power and glory. And Cleveland, her fairest
daughter, whose feet are washed by the commerce-
whitened shores of Erie, whose sinews are iron and
steel, whose brow is forest-crowned, whose heart
is warm with love and nurturing care toward her
own, and whose home-altars glow with generous
hospitality toward the worthy stranger within her
gates, bids you welcome, and tenders to you rest.
' ' No other class of men so need rest. For this
you could well incur the expense of time and money,
and for this your own families could well bid you
God-speed, but the sick and suffering, and the soon-
to-die, whom you have left behind, still plead with
you, as with angel voices, that this respite shall be
improved, not for your own, but for their advantage.
And all the sick and suffering and dying in our vast
humanity could well join in this importunity.
"In your corporate capacity as the American In-
stitute of Homoeopathy you represent the most ad-
vanced truth in medicine, the only rational phi-
losophy of cure, and the surest and safest therapia,
and you meet again to unfold and make known to
each other the treasured results of another year's
study and experience.
140
The Medical Union.
"How important, then, it is that each brings to
this altar his best gift, and gathers therefrom some
truth or suggestion of research or experience not
before his own And how essential it is that no
waste is made of these precious possibilities in
parliamentary circumlocution and routine, or in
Bacchanalian revelries, or by obtrusions of themes
foreign to medicine, or by discussions of self-evident
propositions, or in vauntings of puerile and petling
ideas, or by the effervescence of personal figures, or
in the display of the brandished and clashing steel
of rancorous debate.
" With the eyes of all who feel the blight of dis-
ease, or the curse of pain, or the shadowy touch of
approaching Death turned eagerly toward you, what
inspirations have you to strike hands in loyal and
cherishing brotherhood and move toward a higher
plane of thought and discussion than ever before
attained, and make this session of the Institute
memorable in the history of medicine. "
The President, in his annual address, said :
" Our national body was the first in this country
to organize as a national council of physicians, hav-
ing for its object ' the improvement of the science of
medicine. ' How far the most faithful, if not the most
faultless efforts have been made to carry out this
purpose, the records of twenty-five annual sessions
must testify.
" Of the original members of the Institute, only
about twenty have their names enrolled at the
present time, and among these we find the names
of four of the pioneers of Homoeopathy in North
America, and particularly in this country. I allude
to Constantine Hering, of Philadelphia, John F.
Gray, of New York, Jacob Jeanes, of Philadelphia,
and F. R. McManus, of Baltimore, who forty years
ago were representative men of our school. Imme-
diately after the first convocation of homoeopathic
physicians, to organize a general body, societies
were organized in several of the large cities and towns,
as auxiliary branches, in which were appointed
various and earnest committees to work up and im-
prove all the branches of medicine.
"These societies have gone on multiplying until
all the large towns and cities from Maine to Cali-
fornia, have each an efficient organization. The
change that has taken place within thirty years is
remarkable if not surprising.
" Not only in the towns and cities have these asso-
ciations been formed, but in every county and state
where the members of the profession are sufficiently
numerous to form such a body.
' ' Sixteen states have general organizations, auxil-
iary to this body, "while in each county and town and
city there are tributary branches. This multiplica-
tion of co-operative bodies is now having a wide-
spread influence, it is daily making inroads into every
department of society. Its importance has been felt
in halls of legislation in empires, kingdoms, and
states. We have a striking contrast between the
late proceedings of the Massachusetts Medical So-
ciety and the Legislature of the State of Michigan.
The former, chilled by the unhealthy moisture of
the evening, has retired amidst thick darkness to
indulge in a Rip Van Winkle slumber, while the
latter has arisen surrounded by the nameless influ-
ences of the morning to plant homoeopathy side by
side with allopathy in one of the most flourishing
universities of the West, The ball is still rolling, and
its recognition elsewhere is now bringing about
wonderful transformations in public and private
charities. Even in our own general government
there has been a quasi recognition of our claims by m
the appointment of some of our fraternity to impor-
tant parts in the civil service of the country. We
are safe in regarding this act decidedly prophetic
and a good omen for the future.
" Our national society is looked upon as a center
from which a wide-spread influence should emanate
for the benefit of mankind. Therefore, let it in-
struct its Bureau of Clinical Medicine to point out
rules which can be uniformly of service in establish-
ing, conducting, and recording the practical opera-
tions of as many hospitals and dispensaries as in
every community may be needed or can be sup-
ported. This would tend to improve and augment
the science of medicine, for in every laudable pursuit
practice makes perfect.
"The entire subject of medical education should
come up annually, in county, state, and national
societies, until a brilliant response from our colleges
shows them worthy of being hailed as the sources of
light, crowned with the glory of usefulness and pro-
fessional honor, because they have perfected facili-
ties that cannot fail of swelling the ranks of our
profession with finished scholars, polished gentle-
men, and thoroughly educated physicians and
surgeons.
" The power of the press is everywhere revealed,
and in the service of truth it builds up human in-
terests. It should never be the willing generator of
puerile strife, but the propagator of noble principles.
In medicines it should be the channel of truth, new
discovery, and practical observations. A medical
journal is out of its legitimate sphere when it becomes
the propagator of doctor's quarrels, throwing broad-
cast personal invectives, dogmatic implications and
insinuations of a personal nature. The press, when
controlled by men of doubtful integrity, often proves
a source of corruption, but when governed by good
and true principles, it exerts a wholesome influence.
When engaged in the cause of medicine, or in behalf
of human health, its stand-point should be sufficiently
elevated and pure to send forth as from a fountain,
refreshing streams to invigorate the careworn fac-
ulties of those engaged in professional life.
" It is the duty of an editor, while in the advocacy
of any cause, to cherish liberal sentiments and not
be invidious or dogmatic in criticisms while it is his
privilege to indulge in wholesome review, to point
out errors, and hold them up in the light of truth.
It is not for him to mar the work by going off in
side issues, a few malicious flings, a needless exag-
geration and perversion, for it betokens a littleness
of soul and a want of manly honor which, to say the
least, is sometimes humiliating in our medical jour-
nals. What, then, should be expected of our pe-
riodical literature? It will not be extravagant or
exacting to expect that it will be the medium of
conveying periodically to its patrons the latest achieve-
ments of science and art in medicine and surgery —
the latest record of scientific discovery, of material,
medical, and clinical experience. It should be the
repository of reliable intelligence concerning cli-
mates, watering-places, and retreats for invalids
suffering in body or mind. It should contain well^A
written and exhaustive essays on the treatment or"
specific diseases, epidemics, and endemics, and the
best means of guarding against them. It should
The Medical hnion.
141
discuss the sources of malaria as well as the lethal
intrusions upon the wings of the wind. It should
interest itself in general sanitary measures, scan the
sewerage and drainage of cities, point out what is
defective and how to remedy it ; give explicit direc-
tions concerning the effects of pure water and other
elements of hygiene in promoting the longevity of
the human race."
The report of the treasurer showed that the re-
ceipts of the Institute had exceeded three thousand
dollars during the past fiscal year, and that all
expenses had been paid, with a small balance re-
maining. He offered a resolution, which was
unanimously adopted, that all members of twenty-
five years' standing should be placed on the honor-
ary list, and while they retained the full privilege of
membership, should be exempt from the payment
of future dues.
Dr. I. T. Talbot, of Boston, Mass., presented the
general report of the Bureau of Provings, in which
was announced that the following papers would be
presented: Verification of Symptoms, by W. E.
Payne, of Bath, Me. ; Provings of Eucalyptus
Globules, by E. M. Hale, of Chicago: Verified
Symptoms, by W. McGeorge, of Woodbury, N. J. ;
The use of Sulphur in Acute Diseases, by C. Wes-
selhceft, of Boston ; Provings of Fagopyyrum and
Sulphate of Lime, by T. F. Allen, of New York ;
A Physiological Proving of Vaccine upon Sheep,
by J. Pettet of Cleveland; A plan for the more
thorough and proper proving of remedies and nota-
tion of symptoms for use under the homoeopathic
law, by J. P. Dake, of Nashville (specially ordered
by the Institute).
Dr. Dake then read his paper, which had evi-
dently been prepared with great care. He took
ground in favor of the thorough organization and
equipment of a centrally situated College of Pro vers,
for testing the effects of drugs upon the system ; of
educated and properly qualified Provers, who should
record the effects produced and carry on all their
work under the guidance and control of a Faculty.
The result of these labors would develop the action
of drugs upon human beings, and would be pub-
lished by the college for the use of the entire pro-
fession. This paper elicited considerable discussion.
Dr. I. T. Talbot read a paper by Dr. William E.
Payne, of Maine, on the question whether the
purification of the Materia Medico, can be effected
by re-provings of drugs ; in which the doctor took
the ground that re-proving was unnecessary, and
that the symptomatology of the Materia Medica
was to be purified by clinical verification of these
symptoms.
Dr. J. P. Dake made an eloquent and effective
appeal, at great length, for the plan of re-proving
remedies detailed by him in his paper read during
the morning session.
Dr. D. H. Beckwith, offered the following pre-
amble and resolution touching this subject :
Whereas, In the opinion of the American Insti-
tute of Homoeopathy, a more thorough and com-
plete proving of the drugs now used by the medical
profession is important and necessary, to the end
that the Materia Medica may be purified, so far as
possible, both from errors and superfluities, and be-
come more available for the treatment of disease;
iaerefore
^ Resolved, That a special commission be appointed
by the Institute to memorialize Congress at its next
session in relation to appropriating such a sum or
sums as in the opinion of the commission may be
necessary to establish and maintain a prover's col-
lege, upon such a plan and with such a faculty as
may be deemed advisable.
On motion of Dr. Talbot, the above resolution,
together with the subject of establishing a college of
provers, was referred to a special committee, to re-
port during the session. The chair appointed the
committee as follows : Drs. I. T. Talbot, S. R.
Beckwith, T. F. Allen, T. L. Brown, Lyman
Clary.
The report and papers in possession of the Bureau
of Clinical Medicine, were then presented by Dr. J.
C. 'Burgher, of Pittsburgh. The following papers
were presented :
An Examination of the Apparent Causes and
Results of Treatment in One Hundred Cases of
Phthisis, by H. B. Clarke, of New Bedford, Massa-
chusetts.
Ferrum (iron) versus Phthisis, by E. C. Beckwith,
of Zanesville, Ohio.
Regular and Systematic Respiration of Pure Air as
a Prophylaxis of Phthisis, by J. C. Burgher, of
Pittsburg.
Statistics of Comparative Mortality under Allo-
pathic and Homoeopathic Treatment, by E. M. Kell-
ogg, of New York.
Anal and Rectal Fissure, by W. Eggert, of
Indianapolis.
Clinical Reports of Three Cases Cured by Natrum
Muriaticum, by W. Gallupe, of Bangor, Maine.
Practical Remarks on Pulmonary Consumption,
by W. H. Holcombe, of New Orleans.
Dr. Hall presented a paper on " Hints for the
Management of Pulmonary Phthisis," which was
discussed by Dr. E. C. Franklin.
Dr. J. C. Burgher had a paper prepared on
the Systematic Respiration of Pure Atmospheric
Air.
Dr. R. R. Gregg spoke at length on the pathology
of Phthisis, showing five photographic views of the
microscopical appearances of the different stages of
the disease.
The President announced the appointment of the
Bureau of Materia Medica, as follows : T. F. Allen,
M. D., N. Y., Chairman; H. H. Baxter, M. D.,
Cleveland ; Wallace McGeorge, M. D., Woodbury,
N. J. ; W. E. Payne, M. D., Bath, Me. ; E. M.
Hale, Chicago; O. P. Baer, M. D., Richmond, Ind. ;
J. P. Dake, M. D., Nashville, Tenn. ; Constantine
Hering, M. D., Philadelphia.
The report of the Bureau of Obstetrics was pre-
sented, and the following papers announced : Leu-
corrhcea in its Relation to Menstruation, by Dr. A. B.
Gause, of Philadelphia; Leucorrhcea as a Conserva-
tive, by J. C. Sanders, of Cleveland ; Inversion of
the Uterus, by Dr. Mary S. Blake, of Boston ;
Cervicalis as Related to Leucorrhcea, by Dr. I. H.
Woodbury, of Boston.
The President announced the following appoint-
ments of Bureaus :
Bureau of Clinical Medicine — L. E. Oba, La
Crosse, Wis., Chairman; H. B. Clarke, New Bed-
ford, Mass. ; William Eggert, Indianapolis ; E. C.
Beckwith, Zanesville, O. ; Geo. A. Hall, Chicago ;
W. H. Holcombe, New Orleans ; W. H. Watson,
Utica, N. Y. ; David Cowley, Pittsburgh, Penn. ;
Bushrod H. James, Philadelphia.
142
The Medical Union.
Bureau of Obstetrics—}. C. Sanders, Cleveland,
O., Chairman; I. H. Woodbury, Boston; Safford
Blake, Boston; O. B. Gause, Philadelphia; F. B.
Mandeville, Newark, N. J. ; R. Ludlam, Chicago.
At the afternoon session, the report and papers
of the Sub-Bureau of Gynecological Surgery were
presented. Papers were as follows : Chronic Cervi-
cal Endometritis, by Dr. S. R. Beckwith, of Cin-
cinnati ; Ovarian Cyst, by Dr. C Ormes, of James-
town, N. Y. ; Electrolysis in Ovarian Tumor, by
Willis Danforth, M. D , Chicago.
Bureau for the following year is composed as
follows : S. R. Beckwith, Cincinnati, O., Chairman ;
S. Lilienthal, N. Y. ; R. B. Rush, Salem, O. ; C.
Ormes, Jamestown, N. Y. ; W. Danforth, Chicago ;
M. Friese, Harrisburgh, Penn. ; and N. H. Hunt,
Covington, Ky.
Report and papers on Surgery next presented.
The papers were as follows : Rachitis, by N.
Schneider, of Cleveland ; Bone Tumors, Benign
and Malignant, by E. C. Franklin, of St. Louis ;
Suppuration and Abscess of Bone, by M. W. Wal-
lins, Somerville. N. J. ; Therapeutics of Bone Dis-
eases, by J. C. Morgan, of Phila. ; Necrosis, by L.
H. Willard, of Pittsburgh ; Caries, by C. P. Tief,
of Pittsburgh; Reproduction and Repair of Bone,
by J. H. McClelland, Pittsburgh; Strangulat-
ed Inguinal Hernia, with Removal of Sixteen
Inches of Large Intestine, by H. F. Biggar, of
Cleveland.
In the evening there followed a grand banquet,
at which, in social converse, music, toasts, and
speeches, all seemed to enjoy themselves.
The President made the following appointments
for the Bureau of Surgery, for the following year :
E. C. Franklin, St. Louis, Chairman ; N. Schneider,
Cleveland; L. Pratt, Wheaton, 111.; W. T. Hel-
muth, New York; L. H. Willard, Pittsburgh;
H. F. Biggar, Cleveland; J. H. McClelland, Pitts-
burgh ; G. M. Pease, Boston ; S. R. Beckwith, Cin-
cinnati ; M. McFarlan, Phila ; J. G. Gilchrist,
Tidioute, Pa. ; M. W. Wallins, Somerville, N. J.
The Bureau of Diseases of the Eye and Ear then
presented a report and papers through Prof. J. P.
Wilson, of Cincinnati. Dr. Wilson read a paper on
Diseases of the Eye, and the following were appointed
to serve during the following year : Malcolm Mc-
Farlan, Phila., Chairman; T. P. Wilson, Cincin-
nati; H. C. Houghton, New York; C. H. Von
Tagen ; W. L. Breyfogle, Louisville, Ky. ; W. H.
Hoodyatt, Chicago.
Dr. T. Talbot offered the following, which was
adopted : f
Resolved, That no cases or papers which have
been previously published, be presented to the In-
stitute, or published in its transactions.
A motion was carried to hold the next meeting
at Niagara Falls, on the first Tuesday in June,
1874.
The following were appointed on the Bureau of
Climatology : M. M. Marix, Denver, Colorado ;
W. E. Payne, Bath, Me. ; W. H. Holcombe, New
Orleans ; J. G. Gilchrist, Tidioute, Pa. ; A. K.
Wright, Buffalo ; T. C. Duncan, Chicago ; W. H.
Leonard, Minneapolis ; F. Hiller, San Francisco.
The Bureau of Anatomy, Physiology and Hygiene,
presented its report through Dr. Buck, who also
read a paper on the Hygienic Care of Infants.
Under the Bureau of Psychological Medicine,
papers were read as follows : On the Importance of
Mental Symptoms in our Provingsand Prescriptions,
by C. Pearson, Mount Pleasant, Iowa ; Vital Dyn-
amics, by J. H. P. Frost, of Danville, Pa.
Dr. Lilienthal presented the report of the Bureau -
of Homoeopathic Literature. Three new journals{(
have been added to those already existing, during
the year, and many new and valuable works have
been issued by various publishing houses, three
principal ones by Western authors. Dr. W. H.
Watson, of Utica, N. Y., offered the following
resolutions, which were unanimously adopted :
Resolved, That homceopathists everywhere should
strenuously insist upon the non-violation of the
American principle of "no taxation without repre-
sentation " by sectarian monopolies, either of na-
tional, state, county, or city institutions, supported
by legal assessments, or of those private eleemosy-
nary Institutions which derive support from individ-
ual contributions.
Resolved, That the recognition of this principle
by the Legislature of Michigan, by its action at the
recent session, creating two professorships of
homoeopathy in the university of that state, meets
the most hearty approval of this body.
Dr. Pemberton Dudley, of Philadelphia, present-
ed the report of the Bureau of Organization, Regis-
tration and Statistics. The principal part of the
report was a paper on the comparative mortality
under homoeopathic and allopathic treatment
in the city of Philadelphia during the year
1872. This paper showed that in dropsy on the
brain and other forms of dropsy and marasmus,
the ratio was slightly in favor of allopathy. In
scarlet fever, old age and paralysis, the ratio is
about equal ; while in all other forms of disease,
and all forms of disease taken as a whole, the ratio
was very decidedly in favor of homoeopathic treat-
ment; that is, fewer patients die under homoeo-
pathic treatment than under allopathic treatment.
It was also shown that of those who die there was
considerable difference in the average of their ages
in favor of homoeopathic treatment.
The Institute reassembled at ten o'clock Thursday
morning. A plan has been proposed to centralize
the colleges of the West in one medical university,
to be located in one of the cities of the West ; the
said university to be endowed with a fund not
less than $1,000,000, embracing a faculty competent
to teach every branch in all its departments of medi-
cine, the term of study to cover a period of time
sufficient for thorough education A committee
was appointed to consider the subject, and report to
the next meeting. The Institute then adjourned to
meet at Niagara Falls on the 2d of June, 1874.
The Bureau of Pardology or Diseases of Children
was appointed as follows : Dr. T. C. Duncan,
Chicago, Chairman ; Emma Scott, New York ; F.
R. McManus, Baltimore ; H. N. Martin, Philadel-
phia ; N. R. Morse, Salem, Mass. ; and Nubilung,
St. Louis.
The following officers were elected for the ensu-
ing year: President, Dr. J. J. Youlin, Jersey City;
Vice-President, N. Schneider, Cleveland; General
Secretary, Root. McClatchey, Philadelphia; Pro-
vincial Secretary, BushrodW. James, Philadelphia;
Treasurer, E. M. Kellogg, New York. Board of
Censors, F. R. McManus, Baltimore ; F. F. Pom
roy, Detroit; H. H. Baxter, Cleveland; A
Wright, Buffalo ; Mary Safford Blake, Boston.
The Medical Union.
143
ALBANY COUNTY HOMEOPATHIC MEDICAL
SOCIETY.
At a regular monthly meeting of the Society, Dr.
) Preston read a carefully prepared paper on Urinary
Infiltration, its Causes, and Medical and Surgical
Treatment.
Dr. Paine offered the following resolution, having
reference to the establishment of medical colleges in
Michigan and in Massachusetts :
Whereas, The Legislature of Michigan has re-
cently provided for the appointment by the regents
of two homoeopathic professorships in the medical
department of the State University ; and,
Whereas, The Boston University, chartered by
the State of Massachusetts, with the broadest and
most extensive powers ever given to any educational
institution, has decided to place its medical depart-
ment under the homoeopathic school of medicine ;
therefore,
Resolved, That this liberal action exhibited in two
widely separated portions of this country, is a fitting
rebuke of the bigoted and illiberal proceedings of
the Massachusetts Allopathic Medical Society, in its
star chamber attempt to effect the expulsion of
homoeopathic physicians for simply entertaining
medical opinions differing from those held by the
majority of the members.
The resolution was unanimously adopted.
Dr. Paine stated that prior to the first of January
of the present year, the Atlantic Mutual Life Insur-
ance Company had issued 10,819 policies, 5,429
homoeopathic and 5,390 allopathic. There have
been 156 losses by death, 72 homoeopathic and 84
allopathic. These losses have occurred in all parts
of the country, under the care of practitioners of the
homoeopathic and allopathic system of medical
treatment. Inasmuch as the method of recording
and classifying the risks is conducted with scrupu-
lous accuracy, the result of this rigid comparison
indicates the superiority of the homoeopathic system
of medical treatment. This delicate test shows that
during the first seven years, in the five thousand
five hundred homoeopathic insurants, twenty-six
lives have been saved by adhering to this conserva-
tive system of practice. The following resolution
was then adopted :
Whereas, Well authenticated statistics deduced
from carefully compiled reports of hospital and pri-
vate practice, as well also as the past experience of
this company, clearly demonstrates the results of
the various systems of medical treatment to be so
largely in favor of the homoeopathic method, as to
render it necessary, in order to protect the interests
of practical homceopathists, that they be classified
separately.
Whereas, At least forty per cent, of risks now
being taken by ordinary companies are those of
practical homceopathists, it follows that this class of
insurants, by effecting insurances in such companies,
do so at a decided pecuniary disadvantage, they
being required to bear far more than their own pro-
portion of losses ; therefore,
Resolved, That as the Atlantic Mutual Life Insur-
ance Company is the first, and, with a single
exception, the only life insurance company which
fully recognizes the importance and necessity of
living to practical homceopathists the full advan-
tage of increased longevity, resulting from their own
chosen method of medical treatment, it is a fair in-
ference that the pecuniary interests of this numerous
class will be promoted, and faithfully and carefully
protected, by giving to the Atlantic their prompt,
united and cordial support.
Scientific i&leanings*
Removal of Plaster of Paris Bandages. —
This may be readily accomplished by wetting them
with a strong solution of common salt. It causes
the plaster to crumble, so that the bandage can be
readily cut. It is also useful to clean the hands and
nails of the operator. — Boston Medical and Surgi-
cal Journal.
Absorbing Power of the Human Skin.-
Dr. Thomson, of Edinburgh, states as the result of
extensive experiments, his belief that not only has
absorption by the skin been greatly exaggerated,
but in the case of substances in aqueous solution,
it seems to be the exception, not the rule, for absorp-
tion to take place ; and that in the case of oint-
ments some of the substances so applied seem to
be absorbed and others not.
How to Distinguish Cancer from Innocent
Growths. — Dr. I. N. Dunforth, in writing on the
subject of the great difficulty of recognizing can-
cerous growths under the microscope, says, that
in conclusion, he would lay down the following
simple rules for drawing the distinction between
innocent growths and those that are morbid ; when-
ever a description of one of the cells of a micro-
scopic specimen is a description of all the cells, the
chances are as ten to one that it is not cancer;
whenever, on the other hand, the cells are so varied
in form and size that philology, and ingenuity, and
imagination, and the most unflinching resolution
combined, utterly fail to accomplish the task of
describing them, the chances are as ten to one
that the specimen is from a malignant growth,
whatever may be its name or location.
On Typhoid Fever. — In Sir W. Gull's lecture
on this subject, it is remarked that two hundred and
fifty years ago one of the kings of England died of
ague, but now by improved agriculture and drainage,
the disease has become rare, and certainly very few
die of it. Typhoid Fever, he asserts, is as preventable
as ague, and two hundred and fifty years hence,
death from it will be as rare. The disease is caused
by a virus of nature which may get into the healthy
body, increase in it and destroy it. It is an acci-
dental condition, and not one of the ordinary pro-
cesses of nature. The origin of the disease is in
some way, connected with drainage ; it has there-
fore been called the " filth fever," and to get rid of
the filth is to get rid of the fever. This was illus-
trated in the case of the Millbank Prison, where
typhoid and dysentery were once thoroughly
established, but where both almost wholly dis-
appeared when the water supply was changed and
efficient drainage provided. In his closing remarks
on the treatment of the disease, the lecturer said
that no one can approach a case of typhoid fever
without paying some attention to hygiene. This,
he claims, is of the greatest importance, and with it
he would prefer to carry any one through the dis-
ease by wines and soups and fresh air, rather than
by the use of drugs.
144
The Medical Union.
Lead Poisoning in a Child Eight Days Old.
— Dr. Bouchut was called to see the infant, which
was healthy in appearance, but suffered day and
night with a frightful colic, and finally died. After
its death, it was discovered that the mother was
using for her cracked nipples a quack salve, which
contains very largely of Acetate of Lead
A New Anti-Periodic. — M. Doran has stated
in a note to the Academy of Sciences of Paris
(Comptes Rendits) that he has never known the
laurus nobilis to fail in the quotidian or tertian in-
termittents. Cases yielded to it that were fruitlessly
treated by quinia. He has no doubt that in quartan
ague it would be equally efficient.
The Necessity of Re-vaccination is thus
summed up by a writer in the Sanitarian of April :
' ' The liability to varioloid after ten years of age, of
persons vaccinated under three years of age>. and
the increased liability again from fifteen to twenty-
five years of age, of persons vaccinated or re-
vaccinated at from ten to fifteen years of age,
demonstrates, that generally, protection by vac-
cination under twenty-five years of age is complete
for about seven years only. Subsequent to twenty-
five years of age, protection is complete for a longer
length of time, proportionate to the age of the in-
dividual at the time of the vaccination."
A New Method of Treating Intermittent
Fevers. — Dr. Dedat, of Paris, advocates the use of
subcutaneous injections of carbolic acid for the
treatment of intermittent fevers. The injections
are made under the skin of the chest, abdomen, or
internal part of the thighs, with a small syringe.
The strength of J;he solution is, one part of the acid
to one hundred of water. Four injections are made
the first day, three the second, and two the third.
The first operation, according to Dr. Dedat, always
abates the fever, and often cures it definitively. The
other two are merely a matter of precaution.
3Sfews 3iems*
Dr. Frank A. Rockwith is about to remove
from Newark, N. J., to resume practice again in
East Saginaw, Mich. The doctor will be welcomed
after his long absence by many of his old friends.
He carries with him a ripe experience as a physi-
cian, and a reputation as a skillful and successful sur-
geon. As one of the most indefatigable workers in
the profession, whether as physician, - professor, or
scientist, we predict a success for him in his new
home, and congratulate our Michigan friends upon
this accession to their ranks of one of the most ac-
complished men in the profession.
We are glad to hear that Dr. Pultu of Cincin-
nati is rapidly recovering from a long and danger-
ous illness.
Dr. Shane reports twenty-three cases of gonor-
rhoea quickly cured by the aid of cold ; ice to the
perineum and an alkali to secure its reaction on
the urine.
Dr. Hollister mentions a case of chronic con-
junctivis which was cured by the application of an
ointment of Bin Iodide of Mercury to the outside of
the eyelids.
The Widow of Hahnemann, who still retains
all the freshness of her intellectual vigor, is resid-
ing at Munich.
Professor Buchner, the well-known author of
a work on Morbus Brightii, has recently been deco-
rated with the Wurtemburg Order of Olga.
New York State Homoeopathic Society. —
The Seventeenth Annual Meeting of the Kings Co.
Homoeopathic Society was held at the Brooklyn
Hospital, 95 Cumberland Street, May 13th, and
W. M. L. Fiske, M. D., was elected President for
the ensuing year. A committee was appointed to
make arrangements for the semi-annual meeting of
the State Society in September, consisting of A. E.
Sumner, W. S. Searle, R. C. Moffat, W. M. L.
Fiske, and J. L. Watson. This committee will
do all in their power to make the meeting pleas-
ant, and it is hoped that the attendance will be
unusually large. The morning session will be held
in the Council Chamber of the City Hall, where his
Honor, the Mayor, will welcome the members in
behalf of the City. At one o'clock, the President
of the Board of Trustees of the Hospital will hold a
reception at the hospital, when an opportunity will
be afforded for an inspection of the building. A
collation will be provided at this place, after which
the afternoon session will be held in one of the wards
of the institution. At six o'clock a committee of
the lady managers of the Maternitie will hold a re-
ception at their building, 48 Concord street, when
supper will be served. The evening session will be
held in the parlors of this institution, after which
there will be a reception at the residence of the
Chairman of the Reception Committee, Dr. A. E.
Sumner, 130 Clinton street.
Water as a Cause of Typhoid Fever — The
Medical Department of the London Local Govern-
ment Board has just issued an important report on
the causes of typhoid or enteric fever in London. Of
the various ways in which water may be made the
vehicle for distributing the fever, the report gives the
following as illustrations: "At Terling Place ten
persons were attacked with enteric fever, and all
these persons, and these only of a large family,
drank water from a particular well into which it was
discovered that a cesspool leaked. At Dicken-Bonent,
in Essex, a certain well was polluted, and out of
eighty-eight drinkers from that well, forty-two per-
sons were attacked; while only one other person,
out of a population of two hundred and six, in the
village was attacked. At Nunney, a village in
Somersetshire, having a population of eight hun-
dred and thirty-two, Dr. Ballard records seventy-six
cases of enteric fever as occurring in four months.
The cases were limited in a remarkable way to fami-
lies who obtained their water supply from a small
rivulet which received the sewage of several houses
up stream. At Hawkesbury Upton, in Gloucester-
shire, a village of six hundred and fifty-seven inhab-
itants, within a short period ninety-five cases and
fourteen deaths from enteric fever occurred in groups,
following the successive pollution of different wells
in the village. Burbage, a village in Leicestershire,
as recorded by Dr. Gwynne Harries, had an out-
break of enteric fever from the same cause last year.
No one took the fever in the village except persons
who certainly, or presumably, drank water from A
particular pump, and every house supplied from thP*
pump was subject to infection.
The Medical Union.
H5
iDriginal Articles.
CHOLERA.
By Egbert Guernsey, M. D.
From the east, the south, and the west, come
ominous notes of warning of the existence in cer-
tain localities of that fearful epidemic which more
than once has seemed to girdle the earth like a wave
of death. Sweeping across the ocean, and over
barren plains ; mountain ranges have presented but
little obstacle to its progress ; against strong winds
it has made its rapid way, striking down with its
poisonous breath the denizen of the crowded city
and the secluded hamlet. Meteorological conditions
lead us to suppose that it will not make as rapid
strides this year as in previous epidemics, and, per-
haps, may not appear among us at all, but to those
of us who have once witnessed its ravages, who
have seen men stricken down in a few hours, the
very fact of its existence as an epidemic upon our
shores sends a thrill of terror to our hearts.
Notwithstanding the general belief to the con-
trary, we have reason to believe that the cholera
has not, for the first time, made its appearance in
Europe, and this country in the present century,
but that under other names it has existed and been
attended by great fatality in much earlier times.
The cholera morbus of Sydenham, which was prev-
alent in his time, and of which he gives a pretty
clear account, and the " griping in the guts," re-
corded in England in the mortality bills of 1665,
and described by Willis, seem, from the descrip-
tion, to correspond with the disease supposed to
have been imported from the east. He says : " The
distemper came upon them on a sudden, and often-
times without any manifest cause, and reduced the
patients, by grievous vomiting, frequent stools, and
these watery ones, in a short time to very great
weakness, horrid faintings of their spirits, and de-
struction of strength. Their pulse was weak and
slender, a cold sweat came upon them, and their
breath was short and gasping ; many of them died
quickly of it."
The generally accepted theory of cholera has
been that its birth-place was in India, where it pre-
vailed occasionally from periods coeval with the
earliest record; that in 18 17, it suddenly appeared
and raged with fearful violence in the delta of the
Ganges, and from thence as a centre extended over
the Indian continent. Here for a time it seemed to
pause, as if weary of its conquests, or gathering
fresh strength for its march. In a short time it
spread into China, Ceylon and other islands in the
Indian Ocean, and crossing the equator, broke out
in the Isle of France. Here, upon the confines of
Europe, it paused for several years. In 1829, six
years after its first visit to Astracan, it reached
Orenburg by way of Tartary, and spread rapidly
westward and northward, following the course of the
great rivers, and reached Moscow in September.
The following spring it extended to Archangel, the
most northern port in Europe, and along the border
of the -Baltic to Hamburg, and in October, reached
the northern coast of England. The first epidemic
in England extended from 1831 to 1832; crossing
the Atlantic it appeared in this country the follow-
ing year, and raged with fearful fatality. The next
great epidemic, apparently following a similar
course, appeared at Astracan in June, 1847, at
Moscow in September, at Berlin in June, 1848,
Hamburg in August, in England in September,
and in this country in the spring of the following
year. The epidemics of 1853, and the one follow-
ing a few years later, notwithstanding their exceed-
ing violence in some parts of Europe, seemed to
have spent their force before reaching our shores.
Against the generally accepted theory of India
as its birth-place, and its gradual spread by the
germs being carried by persons, or in a dry state,
from one place to another, dropping the poison
here and there, and kindling into life, virulence
a'nd activity as the poison was set free by moisture
and atmospheric influences, another theory has
been advanced by a distinguished English scientist,
founded on a communication to the Russian Im-
perial Academy of Science.
He holds that, instead of one "home "of the
cholera in the delta of the Ganges, there are seven,
all situated on or near the Tropic of Cancer, equally
distant from each other, of which the most import-
ant is that at the mouth of the Ganges ; the others
are to the east of China, to the north of Mecca, on
the west coast of Africa, to the north of the West
India Islands, to the west of Lower California, and
among the Sandwich Islands ; that a reference to
the map would show that the recorded appearances
of cholera over the globe may be satisfactorily ex-
plained by supposing seven atmospheric streams,
each 1,400 miles in breadth, to proceed from these
foci in a north-westerly direction ; and that at some
periods, as 1833, 1850, and 1866, nearly all the
streams were in activity.
Having pointed out the course of these streams
on a map especially prepared, and showed how the
disease moved within the limits of each, in both
the north-west course and its south-east extension
across the Equator, the author, in tracing in detail
the course of the cholera in India during 181 7 and
181 8, called attention to a remarkable law which
manifested itself, a law which he held was generally
applicable wherever cholera appeared.
Although the course of cholera during 181 7 was
not very clear, still it is evident that it was north-
west and south-west. The lull in virulence and ad-
vance which occurred in December, 181 7, continued
to March, 181 8, when cholera broke out again just
where it had ceased the previous December. The
remarkable law which the author pointed out was
that in 18 18 the cholera advanced simultaneously
in two directions, north-west and south-west, in
such a manner that all the places attacked at any
given time by its north-west advance were situated
at right angles to all the places attacked at the
same time by its south-west advance. This double
advance is made evident by cutting a piece of paper
square, placing a corner upon the map at Calcutta,
and moving it across India in a direct line to Surat.
In 1 8 19 the cholera crossed the Arabian Sea to
Muscat, and passed simultaneously through Persia,
and up to 1823 advanced as far as Asia Minor and
the Caspian, and then died out. In 1823, a fresh
outbreak occurred in India; this steadily proceeded
to the north-west, and halted in the west provinces
of Russia in 1830, and the next year broke out in
full force in the same locality, thus presenting a
parallel to 187 1-2, and went as far as Britain. By
referring to the map it will be seen that all places
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attacked by this stream of cholera in 1831 lie within
the boundaries represented by two lines, one drawn
from the southern point of India to the north of Eng-
land, and the other from the Ganges through Oren-
burg to Archangel. The author having described
with great minuteness the rise and progress of the
other six streams, bringing the subject down to the
present day, stated that Europe was liable to attacks
from two great sources, India and Arabia : Russia
and Northern and part of Central Europe coming
under the influence of the Indian stream; Southern
and Western and part of Central Europe under the
influence of the Arabian. The curious cases of
ships at sea being suddenly attacked by cholera,
and, again, the instances of ships sailing along the
coast of India being struck by the disease when at
the same place, he explained on the supposition
that they had been sailing within the limits of the
cholera streams ; for when they got outside the
limits the disease suddenly ceased. He called at-
tention to a fact worthy of mention, that all the
places recorded by Dr. Gavin Milroy as unaffected
hitherto by cholera lie outside these streams, or in
their possible, but not actual, extension.
Having stated that he was prepared to give, in
another paper on the origin of the disease which he
was preparing, an ample explanation of some well-
known points about cholera ; such as its partial
connection with the east wind, its following the
course of large rivers, its greater prevalence on
tertiary strata, alluvial tracts, and the deltas of
rivers, and its comparative rarity on secondary and
primary strata, the author proceeded : "It was not
my intention at the present time to enter into the
question of the origin of the disease ; but having
read a few days ago that Dr. Buchanan, in this
very hall, congratulated the meeting on being able
to number among the things of the past the time
when the propagation of cholera was supposed to
be due to all manner of cosmic and atmospheric
influences, and on having ' reached a solid basis of
fact and knowledge upon which further observation
might be built with security,' I am tempted to de-
clare that I for one maintain that this despised
theory, which Dr. Buchanan fancies is buried and
put out of sight, is the correct one. I maintain
that cosmic influence lies at the origin of cholera —
that cholera is intimately connected with auroral
and with solar disturbances. I believe that I am able
to show that a remarkable connection exists be-
tween the maxima and the minima of cholera epi-
demics and of solar spots; and in directing your
attention to this map, on which I have represented
graphically the amount of cholera and the number
of sun-spots for the- last fifty years, I wish to show
that there is here also ' a solid basis of fact and
knowledge upon which further observation might
be built with security.' You are all probably aware
that the great astronomer Schwabe discovered that
the sun-spots have what is called a ten-year period ;
that is, there is a minimum of spots every ten years.
It was also discovered that the diurnal variation in
the amount of declination of the magnetic needle
has a ten-year period. The same was proved in
regard to earth currents, and also aurorae. The
maxima and minima of the four were found to be
contemporaneous. This was a great result, but
Professor Wolf, on tabulating all the sun-spots from
the year 161 1, discovered that the period was not
ten years, but 1 1 . 1 1 years. This period is now the
accepted one for the sun-spots, and it has been
established for the magnetic declination, and by
Wolf for the aurorae. Now, it is a curious fact that
the last year of every century, as 1800, has a mini-
mum of sun-spots, so that the minima are 1800,
181 1. 1 1, 1822.22, 1833.33, &c- Tne maxima do
not lie midway between the minima, but anticipate
it by falling on the year 4.77 after a minimum ;
for example, 1800 was a minimum year, then
1804.77 was a maximum year. Now, cholera
epidemics have, I believe, a period equal to a
period and a half of sun-spots. Reckoning then
from 1800, we get as a period and a half the date
1816.66, which was shortly before the great Indian
outbreak ; another period and half gives 1833.33, a
year in which there was a maximum of cholera ;
another, 1849.99, *nat is> ^50, a year having a
maximum of cholera; another, 1866.66, a year hav-
ing a maximum of cholera; another, 1883.33, as the
year in which there will be a cholera maximum. It
follows from what has been already said that 1783.33
would be a year in which cholera was at a maxi-
mum. Now it is a fact that in April, 1783, there
was a great outbreak of the disease at Hurdwar.
" I would call attention to the parallelism of in-
crease and decrease of these curves. I am not,
however, prepared to say that sun-spots originate
cholera ; for they may both be the effects of some
other cause, which may indeed be the action of the
other planets upon the earth and upon the sun. If
that be the case — and I see no reason why it should
not — we may then have an explanation of the minor
periods and of the large period of 56 years, which
Wolf believes he has detected, and also of the minor
periods observed in cholera-epidemics.
u My own opinion, derived from an investigation
of the subject, is that each planet, in coming to
and in going from the perihelion — more especially
about the time of the equinoxes — produces a violent
action upon the sun, and has a violent sympathetic
action produced within itself — internally manifested
by earthquakes, and externally by auroral displays
and volcanic eruptions ; in fact, just such an action
as develops the tail of a comet when it is coming to
and going from perihelion ; and when two or more
planets happen to be coming to or going from peri-
helion at the same time, and are in, or nearly in,
the same line with the sun — being of course nearly
in the same plane — the combined violent action
produces a maximum of sun-spots, and in connec-
tion with it a maximum of cholera on the earth.
The number of deaths from cholera in any year —
for example, the deaths in Calcutta during the six
years, 1865-70 — increased as the earth passed from
perihelion, especially after March 21, came to a
minimum when it was in aphelion, and increased
again when it passed to perihelion, and notably
after equinoctial day ; thus affording a fair test of
my theory."
Whatever may be thought of this theory, it is
certainly ingenious, well-supported by facts, and
worthy of careful consideration. Planetary in-
fluences undoubtedly exert a strong action upon
the magnetic currents of the earth, and through
them, partly through the atmosphere, produce
their effect upon vegetable and animal life. The
researches of science almost daily confirm many of
the practical observations of the old Chaldean
astronomers, who, from their watch-towers on the
hills, watched the stars, and from their movements
The Medical Union.
147
read lessons of good or evil to the world. They
reached conclusions through years of patient
watching and careful observation. Their explana-
tion of the facts observed was strongly tinctured
with their mythology, in which every star and
grove, its mountain and every river was peopled
with their special gods, but the facts remain, never-
theless, to be confirmed to-day by the clear eye of
science.
Sir Ranold Martin, after carefully reviewing the
various theories on the production and spread of
cholera, comes to the following conclusions :
1 . That the disease spreads, through atmospheric
influence or epidemic constitution, by a succession
of local outbreaks, and that the particular localities
affected are determined by certain localizing con-
ditions, which are, first, all those well-known cir-
cumstances which render places insalubrious ; and
second, a susceptibility to the disease in the in-
habitants of such places, produced by the habitual
respiration of an impure atmosphere.
2. That the cause of cholera is a morbific matter,
which undergoes increase only within the human
body, and is propagated by means of discharges
from the bodies of the sick.
3. It is believed that the poison is swallowed, and
acts directly on the mucous membrane of the in-
testines, and is at the same time reproduced in the
alimentary canal, and passes out much increased
with the discharges, and these discharges afterward,
in various ways, reach the alimentary canals of
other persons, and produce a like disease.
4. Assuming that the cause of cholera is a
morbific matter or poison, it is probably reproduced
in the air, as well as within the bodies of those it
affects, and that its diffusion may be due, to a
certain extent, to the agency of the atmosphere.
5. It is believed that the cholera poison is in-
creased by a species of fermentation or other mode
of reproduction, in impure, damp, and stagnant
air; and it is maintained that it, nevertheless, is
distributed and diffused by means of human inter-
course, being carried in ships and other vehicles,
and even in the clothes— especially in the foul
clothes of vagrants and the accumulated baggage
of armies.
6. It is assumed that the material causes of the
disease may be increased and propagated in and
by impure air, as well as in and by the human
body.
All of the theories agree that cholera is induced
by a special poison, and most of them that this
poison is of foreign extraction, reaching our shores
and extending from point to point by means of
direct human intercourse, by positive or individual
contagion, or sweeping from point to point from
some of its great breeding centres, by a kind of
wave-like extension.
The general theory is that it is not directly con-
tagious in the general acceptation of that term, but
that the poison germs are developed or vitalized as
the emanations from the body, especially through
the bowels and stomach, are acted on by atmos-
pheric influence and local conditions. These
germs do not immediately develop their poison,
and may be destroyed by proper precautions and
the free use of the necessary disinfectants. The
soiled clothes may be washed immediately, as a
general thing, without communicating the disease,
but thrown one side for a short time, the poison is I
developed ; especially in a moist air or in the process of
washing. The germs are undoubtedly carried from
place to place through articles of clothing in a dried
condition. We know that this condition entirely
protects . organic bodies from certain molecular
changes, so that as long as the clothes are in a dry
state, no definite limit could be stated as to how
long the morbific agent might retain its specific
powers. Thus, a single case might give rise to a
wide-spread infection.
We can readily see then, how, in thickly popu-
lated localities, the seeds of the poison may sweep
through the streets in the form of cholera dust ris-
king from the soil and even the clothing in which it has
found a lodging, how it may lurk in the damp alleys
and dirty streets and houses, and be swept on in a
rushing tide of death through the sewers, from one
end of the city to the other.
Meteorological conditions and localizing causes
have much to do with the development and spread
of cholera. Those who remember the fearful epi-
demic of 1849 fail to recognize this summer those
peculiar meteorological conditions which existed
then. The stagnant atmosphere, the rapidity with
which all animal matter decomposed, and the evident
lack of vitality in the air, do not exist this summer,
especially in the northern part of the country, and
unless some very marked change speedily takes place,
the danger of a great epidemic this season will be
slight.
According to the delicate and accurate observa-
tions of Mr. Glaisher, the three visitations seem to
have been remarkably similar, except in temperature,
and especially as to the condition of the atmosphere
which was thin in high places and dense in low, the
absence of motion in the air, high readings of
the barometer, and a total absence of ozone.
Such conditions favor the chemical decomposition of
organic substances, the stagnant air failing to de-
compose and disperse into space the products of
decomposition. In the epidemic of 1849, and to
a less extent in the two following epidemics, because
they were less severe, the cholera was preceded by a
severe form of diarrhoea, choleric in its character,
and followed by a malignant type of dysentery,
which often assumed a typhoid character. During
that summer I was practising in a country town
through which the Hudson River Railroad was then
being built. Within a circuit of eight or ten miles
were several large manufacturing villages, while
here and there were interspersed the beautiful
country seats of the wealthy. In all this region
there was scarcely a house in which disease in some
form did not enter. All the medical men were
busy night and day. In the commencement of the
epidemic my own practice, which was homoeopathic,
was particularly successful, so that, as the disease
spread through the surrounding country, my labors
increased. My wife has since informed me that for
four months I did not sleep in my bed a single night
without being called out. In fact most of my sleep
was taken in my carriage.
Symptoms of Cholera. — We recognize in cholera
two distinct stages: The stage of invasion, rapidly
running into the cold, pulseless, or asphyxiated
stage, and the febrile paroxysm which follows
it. The invasion is usually sudden where the dis-
ease is violent, although it may have been pre-
ceded by slight diarrhoea for several days. The
patient is stricken down as by a blow, and finds
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himself passing in a few hours from a state of com-
parative health to an almost total extinction of all
the vital powers. The cold stage varies from a few
minutes to several hours, while the hot stage, which
often rapidly assumes a typhoid condition, may last
from a few hours to three or four weeks. So sudden
is the attack and course of the disease, that in a few
hours from the first invasion the patient is often
cold in death. In the epidemic of 1849, I remem-
ber a young man, about twenty, of strong, vigorous
constitution, whose voice, in the closing anthem of
the Sunday morning service, was noticed to be un-
usually clear and strong. He went to his home
across the street, was stricken down with cholera,
and in three hours was dead. What weapons are
there in the armory of any school to cope with an
attack like this ?
The disease is, as I have said, frequently, though
not always, preceded by a painless, watery diarrhoea.
Suddenly he is attacked with sickness and vomiting
and a profuse diarrhoea, like rice water with small
flocculi floating in it (although in rare cases, the
cholera sicca, there is no diarrhoea), gushing from
him in torrents, as if all the fluids in the body were
escaping, followed by an extreme sense of exhaustion,
the patient sometimes fainting or staggering like a
drunken man to reach his bed. No wonder he is
exhausted, for this is a hemorrhage of the serum of
the blood, and the vital forces sink as if the crim-
son tide was pouring out from an artery or vein.
The temperature sinks below the normal standard.
The skin becomes shriveled, is icy cold, and a cold,
clammy perspiration starts out from every pore ;
the cheeks are hollow, the lips livid, the eyes sunken,
the face sharp and pinched, the breath cold, and
the voice hoarse as he tosses about and constantly
pleads in that sepulchral voice which seems
to come from the grave, for water. The cup is
clutched eagerly and the water drunk, only to be
thrown from the stomach, giving no relief to the
burning, consuming thirst. Now comes on the
fearful cramps in the toes, the arms, the legs, the
abdomen — the result of the abstraction of the fluids
of the body and the lack of arterial stimuli — causing
the patient to shriek and groan in agony. While
every other organ of the body seems rapidly sinking
into ruin, the brain retains its clearness almost to
the last breath, being the last to yield to the touch of
death. After death the temperature of the body
usually rises and the form loses, to a certain extent,
its shriveled and shrunken appearance.
If the patient survive the cold stage, he may
rapidly recover, but it is usually followed by a febrile
stage, lasting from a few hours to several days, and
often assuming a typhoid type ; as it assumes this
form, the tongue, at first white, soon becomes dry
and brown, while the lips and teeth are incrusted
with black sordes. The eyes are red, the cheeks
flushed, the pulse rapid, but the temperature but
little above the normal standard. These symptoms
speedily disappear as the patient becomes delirious
or comatose ; the disease, if fatal, terminating in the
usual manner of typhoid fever. In the cold stage
of cholera the blood is of an unnatural dark color
and thick consistency, but as the febrile stage comes
on, the quantity of the serum increases until it be-
comes more abundant in the blood than natural.
Pathology. — The liver and spleen are engorged
with blood, even the bones looking as if they were
stained with madder. The bladder is contracted
and empty. The membranes of the brain and cord
congested and dotted with puncta cruenta. In the
lungs the blood is found chiefly in the large vessels,
although sometimes the minute structure is filled.
The right side of the heart and the pulmonary
arteries are generally filled, while the left side and
aorta are usually empty. This is the appearance
of the body when death has occurred during the
cold stage. In the hot stage the blood is recalled to
the surface of the body, and the livid and shrunken
appearance disappears.
Treatment. — In no disease is the benefit of a treat-
ment based upon scientific principles more apparent
than in cholera. The Allopathic school, with no
principle to govern them in selecting of a remedy,
find themselves reduced to general theorizing, and
their remedies are almost as varied as the individual
prescribers. Dr. Bushnan, in a little work pub-
lished in London in 1850, on cholera and its cures,
gives the following graphic picture of his own school.
"The remedies," he says, "defy classification.
Omitting for a moment the complex method by
which cholera was to be vanquished, what were the
simple specifics that were to infallibly cure the fear-
ful enemy.
" Water of every temperature. Wrap the cholera
patient in a cold sheet, says one. Dash cold water
repeatedly over the sheet in which he is enveloped,
says another. Ply him well with cold water inter-
nally, says a third. Freeze him : cool his blood to
thirty below zero, adds a fourth. Fools that ye are,
exclaims a fifth, thus to treat a patient half dead
with cholera — I say, wrap him in sheets soaked in
boiling water, and having thus half cooked the
shivering wretch, conclude the process by placing
him over the boiler of a steam engine.
" Sage advice, learned Thebans ! The blood is
dark and the surface cold. ' My theory,' shouts one
man, ' is that oxygen reddens the blood, and by its
action on that blood generates heat; therefore
make the patient inhale oxygen.' 'Nay,' rejoins
another, ' the blood in the lungs is too bright ; oxy-
gen has nothing to do with the generation of heat ;
stifle him with carbonic acid.' 'There are cramps
present, which cause much suffering, and therefore
are they the symptom especially to be treated.
Chloroform annihilates pain — let him breathe chlo-
roform. '
" ' It is evident,' avows one sapient doctor, ' that
there is no bile in the stools ; therefore calomel
should be administered.' ' It is plain,' says another,
' that diarrhoea is the great evil ; therefore let him
have opium — that is the drug which effectually pre-
vents a free flow of bile.' 'He is cold and de-
pressed— what so natural as to stimulate. ' The wis-
dom of the proposal is proved by the numbers who
recommended its adoption — the folly of the many-
is manifested by the proportion who died under the
use of stimulants. ' Give him alkalies,' vociferates
one man. 'Nay,' says another, 'lemon juice and
acid are the true remedies.'
"'It is simply a stage of intermittent fever,'
maintain some ; 'therefore,' they add, ' the drug for
its prevention and its cure is quinine. ' Not half
potent enough,' whispers a supporter of the same
theory, ' give him arsenic'
" Certain fanatics refused the use of medicine,
but, in the course of their religious mummeries,
administered to the credulous a cup of olive oil. A
patient recovered, and ' Eureka ' shout the popu-
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149
lace. Vox et praeterea nihil, say those who wait
awhile before they decide.
" Opium, in one man's mind, is a specific in small
doses — the twentieth part of a grain, frequently
repeated. ' Nonsense,' says another, ' opium is a
specific, but let it be given in doses of from six to
twelve grains.' The latter has one advantage: if
the power of absorption yet remains to the stomach,
the patient will assuredly be saved all further pain,
and, if he be a good man, mercifully provided for
in a better world.
" ' Calomel is the specific that will stay every
symptom of the cholera, bring back the pulse, and
restore life almost to the dead, if given,' says one,
'in twenty or thirty grains at a dose.' ' No,' says
another, ' give it in that way and you will kill the
patient. It must be given in small doses at short
intervals.'
" Then come other infallible specifics— pitch, sul-
phur, phosphorus and carbon ; gold, silver, zinc,
and lead ; strychnine, salicine, morphine and can-
nabine ; hachshish and zeorabia ; abstraction of
blood and injection of blood ; perfect repose and
incessant motion; to the skin irritation the most
severe, applications the most soothing ; stimulants
the most violent, sedatives the most powerful."
From this picture of the intelligent ability of a
great school of medicine, claiming in its ranks all
the science and all the regularity in the medical
world, to cope with a terrible pestilence, we turn to
the treatment of the homoeopathic school. With
much to learn both about the nature of the disease
and the character of its treatment ; failing often
where, with a more thorough knowledge of the
malady and the remedies, we should succeed ;
still we can point to more positive results in treat-
ment than any other school, and a unanimity of
action in investigation and treatment based upon
scientific laws.
During the prevalence of cholera, particular at-
tention should be paid to the general health ; clean-
liness and careful ventilation, at all times desirable,
are now of especial importance. We should see
that, as the peculiar condition of the stagnant air
causes quick and rapid decomposition of animal
and vegetable matter, no food should be used
with the least possible taint or decay. While the
bowels should be kept open, violent cathartics
should be avoided, and the first symptoms of that
watery and painless diarrhoea, which sometimes
precedes the direct cholera attack, carefully looked
after.
Ipecac, Veratrum, and Camphor are all capital
remedies for the premonitory symptoms of diarrhoea,
the Ipecac, sometimes relieving also the nausea of
the disease itself when the purging is not excessive,
The first remedy thought of in the genuine attack
of cholera is, undoubtedly, Camphor, but to be of
any benefit it should be given several drops at a
dose, and often repeated. I have stated on another
page my experience in an accidental case of poison-
ing by Camp ho?', the symptoms closely resembling
those of cholera.
Veratrum is indicated from the commencement,
and I have generally given it after a few doses of
Camphor have first been administered, if I failed to
get from that drug the desired effect. When the
disease has so far advanced that the pulse has be-
come almost extinct, and the dull apathy of the pa-
tient shows that the powers of reaction are fast
waning, the drug ceases to produce any beneficial
result.
I usually alternate Cuprum with Veratrum all
through the vomiting, diarrhoea, and spasms, con-
tinuing its use in the frigid and asphyxiated stage.
The spasmodic twitching of the fingers and toes,
the agonizing but ineffectual effort to vomit, the
loss of consciousness, all point to this drug as indi-
cating the approaching general paralysis of the or-
ganism. I prefer the Acetate of Copper to the
Metalic, and never give it higher than the second
attenuation.
The indications for Arsenicum are sudden and
, rapid prostration, intense thirst, with constant vom-
iting of everything taken into the stomach, burn-
ing in the region of the stomach, and great anguish.
The Hydrocianic Acid is also indicated in sudden
and violent attacks, where the whole organism
seems to be paralysed in its action and sinking
down in hopeless ruin from the first blow. If it does
any good its action will be prompt and decided.
In the collapse stage, we at once recall by the
vivid picture before us, the poisonous action of
Aconite. The deadly chill, the pale face, the dilated
pupils, the quick and contracted pulse sometimes
scarcely felt, and the tetanic spasms give us a start-
ling picture of Aconite poisoning. This drug is
used by many of the India and Southern physicians
in the terrible congestive chill, which seems at once
to paralyse the centres of life, destroying conscious-
ness from the outset, and unless promptly relieved,
speedily terminating in death. It will sometimes
check the march of the disease when every other
remedy has failed, but it should be given in decided
doses, and often repeated. Twenty drops of the
tincture in a glass half full of water, and a teaspoon-
ful every ten or fifteen minutes is not too much in
these urgent cases where death seems to be hovering
at the threshold. I have saved cases with this drug
given in this way, which seemed to be entirely hope-
less, and experience in a matter like this, founded
on scientific premises, outweighs a host of fine-spun
theories formed in the quiet of the study.
The incessant call for drink had best be met with
crushed ice, toast water, rice water, carbonic acid
water, and sometimes iced champagne, or brandy
and ice, given a little at a time and often repeated,
Warm blankets and friction are useful to keep up
the circulation and relieve the fearful spasms and
cramps. As soon as the vomiting has subsided,
easily digested food requiring but little action of the
stomach, can be given a little at a time, carefully-
feeling the way.
The treatment of the typhoid stage is that usual
in typhoid fever.
I have said the poison germs can be destroyed by
the prompt use of appropriate disinfectants. Ten
pounds of Sulphate of Iron (copperas) should be
dissolved in five gallons of water, and to this should
be added half-a-pint of common carbolic acid. A
small quantity of this should be constantly kept in
the vessel which is to receive the discharge. A pint
should be poured into the water-closet three or four
times a day. The seats and floor of the water-
closet should be washed with carbolic acid, an ounce
to the gallon of water. Clothing, sheets, and
towels from cholera patients should be at once
boiled or thrown into a tub of water, in which has
been dissolved eight ounces of Sulphate of Zinc,
with one or two ounces of Carbolic acid to every
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three or four gallons of water. Fresh stone lime
should be placed in damp closets and in cellars,
and offensive gases destroyed by Chloride of Lime.
These precautions are essential to aid in checking
the progress of the disease, and will materially help
to stay its advancement.
OBSERVATIONS ON OVARIOTOMY.
By Dr. Ad. Maylander.
Health Inspector and Director of the Homoeopathic Surgical Hospi-
tal and Clinic in Berlin.
(Translated and Condensed by W. N. Guernsey, M. D.)
Dr. Ad. Maylander gives in the Allgemeine
Homceoftathische Zeitung a series of interesting arti-
cles on ovariotomy, from which we cull the follow-
ing:
By far the most frequent cause of a fatal
termination, after the operation of ovariotomy, is the
occurrence of peritonitis. This, in the majority of
cases, is not of the diffuse form. Nevertheless, it
runs a very rapid course, and collapse speedily sets
in, appearing shortly after the operation—/. <?.,
within the succeeding thirty-six hours. Its out-
break is announced by a rapid and persistent eleva-
tion of the temperature to over 380 (ioo^° F.),
continuous green vomiting, and the sensation of
great anguish.
In medical practice such cases are rarely ob-
served, except in those instances of perforation
where septic matter has penetrated directly into the
peritoneal cavity from the stomach or the intestines ;
while, on the contrary, simple peritonitis, when
treated early is, at least according to my experi-
ence, not to be reckoned among the most rapid or
dangerous of diseases. Also, the peritoneal inflam-
mations which follow surgical operations where the
peritoneal cavity is not opened, ordinarily run a
favorable course even in the severe cases where the
exudation is profuse, and it undergoes purulent
degeneration. // is evident, therefore, that the
admission of the atmospheric air into the cavity of
the peritoneum must be regarded as the engendering
cause of the septicemia which so closely follows.
The influence of the same upon the decomposition
of the secretions which exude from the wounded
surfaces must be rated as very great.
In 144 cases of ovariotomy that terminated fatally
from peritonitis, which I gathered from the books
accessible to me and from my own practice, the
autopsy revealed diffuse peritonitis in only a very
small number of them. Death occurred in twenty-
two cases within twenty-four hours, in forty-six cases
within two days, thirty-two times on the third day,
twenty-three on the fourth, ten on the fifth, four on
the sixth and seventh, twice on the eighth, and once
on the ninth. Some of the older physicians have
surmised that the stormy {foudroyante) course of
septic peritonitis might have its foundation in the
peculiar arrangement of the lymphatic vessels of the
peritoneum, as rarely in any other portion of the
body does the septic process run its course to a fatal
end in such a violent manner. The old theory ad-
vanced by Mascagni that serous cavities were in
direct and open communication with the lymphatic
vessels was partly confirmed by the experiments of
Von Recklinghausen, Schweiger-Seidel, Ludwig
Dybkowsky and Dogiel upon rabbits, dogs and
frogs.
According to Von Recklinghausen the lymphatic
vessels of the central tendon of the diaphragm of
rabbits are in direct union with the peritoneal cav-
ity through apertures twice the size of a blood cor-
puscle. Further experiments show that these
openings, both during life and directly after death,
not only admit liquids but take up finely-divided
particles of cinnabar, and madder as well as milk
globules, blood cells, &c, and that a spontaneous
injection of the lymphatics with these substances
result, if they are placed within the peritoneum of a
living, or upon the epithelium on the under surface
of the diaphragm of a slaughtered animal. The
great probability that there exists in man a similar
distribution is of great importance in practice, and
especially of moment to the ovariotomist. It
prompts us to seek for a remedy which would
paralyze the action of the lymphatics opening
into the peritoneum so that they could not suck up
for a time any substance from that cavity. Then
we would be able to escape the most immediate and
greatest danger of a direct and general septic infec-
tion within the first two or three days after the oper-
ation.
This question, more than two years since, engaged
my attention, when an ovariotomy in Halle ended
fatally within twenty-four hours after the operation.
Reference was made at the time by Professor Volk-
mann to an experiment with the Calabar bean for the
purpose of attaining this end. Unfortunately, at
my next operation, I did not have a good and- relia-
ble preparation with me, and so I failed to make
any experiment with it. I deeply regret that we
have as yet no physiological provings of the Calabar,
and would earnestly urge that they should be made.
Among the effects produced by the Calabar bean
which are known at present, aside from its well-
known action of contracting the pupil, that of its
causing contraction of organic muscular fibres
seems to be most firmly established.
Here the establishment of the fact that at least
the larger lymphatic vessels contain not only con-
tractile but unstriped muscular fibres is of great
importance. Kolliker's experiments in reference
thereto are of great interest, and show that the
lymphatic vessels are possessed of three layers!
First, an Inthfia, composed of the epithelium, and a
single or double layer of connective tissue, with
fibres running lengthwise, which, according to Wey-
rich, are wanting in the lymphatics of the messentery,
yet are always found, according to Kolliker, in those
of the lumbar plexus and in the extremities ; second,
a Media, formed of unstriped muscular fibres which
run circularly across the former, and of fine elastic
fibres which also run in a similar direction ; third,
an Adventitia of connective tissue, running longi-
tudinally, a thin network of fine elastic fibres, and
a great number of oblique and longitudinal bundles
of unstriped muscular tissue.
With these facts in view, I made, in the case nar-
rated in the previous article, the first experiment
known with the administration of Calabar bean, as
a prophylactic ; I administered the tincture of Cala-
bar bean, 1.10, as preparatory treatment, three days
previous to the operation. On the first day I gave
one drop every three hours, on the second two
drops, and on the third three drops as a dose, at
similar intervals. Although I am not so sanguine
as to draw extensive conclusions from the happy
termination of a single operation, yet the very
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151
favorable result attained in spite of a complication
of inauspicious symptoms, encourages further ex-
periments. In the case mentioned above, although
her constitution was greatly reduced by having
been tapped six times, and the withdrawal of about
150 pounds of richly albuminous serum, in spite of
almost the entire adhesion of the tumor, and the
considerable hemorrhage into the peritoneal cavity
at and after the operation, and notwithstanding the
ligatures were perhaps too sparingly used, there
resulted, neither during the operation nor the whole
after-treatment, no fever worth mentioning, nor the
slightest sensation of pain.
The patient, throughout the whole time, felt per-
fectly well, not even having suffered from intestinal
catarrh.
The objection might be raised that the opening
of a diseased peritoneum, especially of one where
extensive adhesive inflammation had previously ex-
isted, is ordinarily less dangerous than in those
relatively healthy, as in similar circumstances, the
opening of a diseased joint is infinitely less danger-
ous than that of a healthy one. (We will not speak
here of the supposition that in synovial cavities
there probably exists a similar direct inosculation of
the open lymphatic vessels, as in serous sacks ; and
that the principal danger of opening joints and
the admittance of atmospheric air and the ensuing
inflammation probably arises from the direct and
unimpeded absorption of pyogenic matter.) There
are many who maintain this view, although the
majority do not coincide with it. It is a fact that
in by far the greater majority of successful cases of
ovariotomy, there have been either very little or no
adhesions present; and, moreover, that in those
cases where the peritoneum showed evidences of
disease, even where no adhesions existed, the opera-
tion of ovariotomy has almost always ended fatally.
The question is to be only decided by further ex-
periments and statistics. As yet, the presence
of extensive adhesions of an ovarian tumor, even
when they are not inseparably attached to important
organs, is not regarded as of more favorable import
for the prognosis.
I would advise that in every case Calabar bean
be given forty-eight hours previous to the opera-
tion, experimentally as a prophylactic against septic
peritonitis. I would give it in the after-treatment
also, administering three drops every three or four
hours. If the temperature should rise within the
next few hours after the operation, I would alternate
it with Aconite, 2 or 3. If within the next sixteen
or eighteen hours no considerable elevation of the
temperature occurs, or if it abates to nearly its
normal condition, I would discontinue the Calabar,
and give Aconite and Arnica alternately every two
hours. With the first appearance of pain, I give
Morphine promptly. It is also the most efficacious
remedy in relieving persistent nausea and repeated
vomiting.
Cod Liver Oil Pills.— Dr. Van der Court, of
Brussels, prepares cod liver oil pills by adding,
carefully, pulverized slacked lime to the oil, little
by little, until the consistency for forming into pills
is obtained. Of this mass he gives four or five
grains at a dose. This remedy he considers
in many respects better than the liquid oil, es-
pecially in the early stages of consumption and
in its chronic form.
CLINIC OF THE BROOKLYN HOMEOPATHIC
EYE AND EAR INFIRMARY.
In Charge of W. S. Searle, M. D.
Case 1. — Dec. 28. Delia R., aet. 27, has noticed
that her vision had diminished during the past
month. V. r. 10.70 1. 10.10, Read's J., No. 5, but
only at 10 " . Amount of myopia undetermined.
Milliary conjunctivitis in both eyes. Lids feel heavy
and droop. At times sharp, darting pain in r. eye.
Ophthalmoscope shows chorioretinitis on this side.
Left normal. A. good. B. regular. Complains of
a dazzling sensation on looking too long at an ob-
ject. No headache. PjL- Zinc Met. 3, 3 hrs. Jan-
uary 3d, reports no better. F>; Spig. 3, 2 hrs. 22d,
better, but r. eye still cloudy. Lias lately noticed a
yellow halo around the gas-light. PjL Santonin 3,
2 hrs. March 1st, reports that she soon became
quite well. Now has a cold, which has occasioned
much photophobia and lachrymation, with pain of
a darting character in the right eye. F> Spig. 30,
3 hrs. Did not return.
Case 2. — Flora W., aet. 5, when an infant, had oph-
thalmia neonat, which resulted in perforating ulcers
of both corneas. These have been healed for years,
but the consequent leucornae being nearly central,
vision is so far lost in the left eye as to render it
practically useless ; while in the right eye there is
only a border of clear cornea left, about one line in
width. There are, of course, anterior synechae in
both eyes, but in the left, the lower border only of
the pupil is implicated. Nystagmus is present in
an exaggerated form.
Iridectomy was made (December, 1872) upon the
left eye from above and was successful. At the pres-
ent writing (June, 1873) it is impossible to tell the
exact amount of vision, because of the still tender
age of the child ; but she readily distinguishes ob-
jects of half a line in diameter. The case is simply
mentioned to record the curative effect of the opera-
tion upon the nystagmus. The eyes now roll only
when the child labors under mental excitement.
Case 3 . — March 5th. Ed. F., aet. n, was brought
to the Clinic. He has suffered for years with re-
current phlyctenular keratitis. Has now a central
ulcus on the left cornea. There is much bland
lachrymation with acrid coryza. The eye burns,
and feels " as if it were going to drop out." There
is intense photophobia with some ciliary neural-
gia. Tongue too red — a diffuse redness, but more
in the centre; thick, yellow coat at the root. He
is pale and thin from confinement and protracted
suffering. No glandular swelling, but he is evident-
ly scrofulous, as are nearly or quite all patients who
suffer with this and similar diseases of the eye.
Bell. 30, and Euph. 30, were given with rather
fitful improvement until March 23d, when nothing
remained to mark the sight of the ulcer but a small
leucoma ; all other symptoms had vanished. Im-
proved nutrition had followed upon a diet of milk,
meat and eggs, and fruit, together with more exer-
cise, and he looked like a different boy. F> Hep.
30, 3 t. d. March 29th, leucoma rapidly disappear-
ing.
I do not look for a recurrence of the disease in
this case, because of the improvement in general
health. We may ridicule the idea of Psora, but
call it what you will, there is a constitutional condi-
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tion back of this disease which must be changed be-
fore a radical cure can be effected. Hence the allo-
pathic treatment, by the instillation of Atropine,
and of the "yellow ointment," affords only a tem-
porary relief and one not speedily obtained often ;
while the homoeopathic treatment, being adapted to
the modalities of each case, cures not only more
speedily but thoroughly.
Case 4. — May 21st. Mary Coffee, set. 27, has
noticed failure of sight for three years ; and during
the past six weeks (having been sewing quite stead-
ily) she has pain of a burning, smarting character
at the back of the globe of both eyes. When she
attempts to sew, she feels "as if the eyes would
burst from their sockets." Has most pain in the
left eye. Is hypermetropic % 4, V. 1. 10.10, r. 10.
70. Ophthalmoscope shows hyperaemia and a blur-
red appearance of the r. optic disk. Left is normal.
To use X 20 glasses, and take Ruta, 3, every three
hours. April 1st, vision perfect with glasses, and
no pain.
Case 5. — April 23d. Edith F., aet. 14, has recur-
rent phlyctenular keratitis. Has had it for years.
It now affects the left eye. Is pale and thin. Since
six weeks has loss of appetite. Desires acids. Has
pain in the long bones at night. Hyperaesthesia of
the surface of the thorax, with short, hacking cough.
T. feels often as if it had been burned. Menses
regular, but the flow is venous. Feels best in cool
air. r> Mez. 30, 3 t. d. April 28th, eye well and
general health much better.
April 10th. Mrs. P., aet. 40, has noticed since
two weeks that the vision of the right eye was dim.
Oblique illumination shows an exquisite case of ker-
atitis punctata. Has right frontal headache, T.
moist and white, prominent red papillae on the tip.
r> Bell. 30, and Merc. S. 30, alternately, every 2
hours. April 14th, better, p> same every 3 hours.
April 23d, better, Hep. 30, 3 t. d. April 29th, re-
ports well.
Case 6. — January nth. Hannah K., aet. 5, two
years ago had scarlet fever, which left her with an
otitis media purulenta. There is a thick, yellow
and somewhat offensive discharge. H. d. for watch,
contact on both sides. Has also pityriasis of the
scalp. r>- Merc. S. 200, 3 t. d. and the following,
which is to be dropped in the ear after syringing
each night: r> Argent, Nit , grs. v., Spiritus Vini,
Aquae, aa ^ss. m. January 16, better, discharge less,
R same. January 30, better, some pain in the ear.
A little discharge which is very offensive, r> Hep.
3, and Puis. 3, every 2 hours. February 25th, no
discharge until a little to-day. Scalp same. J^L
Psurin 30, 3 t. d. Did not return.
Case 7. — March 24I George F., aet 4., since three
days, has acute otitis media of both sides. H. d.,
uncertain. Both m. t. much injected. Pain worse
at night, but continues during the day. T. dry and
red. Lips very red. r> Bell. 3, Merc. P. 3, 2
hrs. Glycer. 3 iv. & Aeon, o gtt. X to be dropped
in the ears. March 30, reports well.
Case 8. — March 24. Hannah B., aet. 8, is deaf since
one year. The speculum shows chronic aural ca-
tarrh. Hears better after blowing the nose H. d.
8 a on each side. Pharynx red with some naso-
pharyngeal catarrh. Politzer X, rjL Merc. Prot 3, 3
t. d. March 28, better. H. d., r 10 " 1. n % Hep.
3, n. Puis. 3, 3 t. d. April 5, H. d. normal. fy
Sulph. 30, n. o. m. and discharged.
Abbreviations. — H. d. = hearing distance.
Politzer X. = improvement after the use of Po-
litzer's method. 1 " = 1 inch 1/ = 1 foot. T.=
tongue. A. = appetite. B. = bowels. J. = Jae-
ger's test type. V. = vision. X 20 glasses = con-
vex 20.
CLINICAL SURGERY.
PIROGOFF'S OPERATION. — PERFORATING RUPTURE
OF THE PERINEUM. — GANGLION, HYDROCELE
AND NiEVUS TREATED BY ELECTROLYSIS.
By John C. Minor, M. D.
Pirogoff's Operation. — A. M., a girl 16 years old,
came under my care May 1st, 1866, for caries of the
bones of the right foot. A year before, she had,
while running barefoot in the country, stepped upon
a sharp spicula of bone, which penetrated the
plantar fascia and tissues of the foot. This accident
had been followed by extensive inflammation ; the
pus burrowing among the tissues surrounding the
metatarsal bones and giving rise to intense pain and
grave constitutional symptoms. When I first saw
the patient she was in the last stages of exhaustion,
wasted to an extreme degree from the profuse dis-
charge and from suffering ; she was so reduced by
hectic fever and by the causes I have mentioned
that she was unable to sit up even in bed, and the
friends and family had abandoned all hope of her
recovery. On examining the foot I found it enor-
mously swollen. The integument and plantar fascia
had been entirely lost by sloughing, except that por-
tion just beneath the os calcis. There were several
fistulae leading down to the diseased bones and the
probe at once revealed a carious condition of the
tarsal bones, with the exception of the calcaneum
and astragalus, and the metatarsus appeared to be
necrosed. Under these conditions amputation was
the only proper treatment, but the patient was in
such a precarious state that I dreaded the effect of
surgical shock upon her feeble system. Having
carefully considered the case, I expressed the opin-
ion that she would probably die from the shock of
the operation, but that nevertheless there was a
certainty of a fatal result unless amputation was
performed, and hence I felt it to be my duty to ad-
vise the operation as the only chance for life. The
patient decided the matter herself by requesting me
to operate at once. Pirogoff's method appeared to
me best suited to the case, and accordingly I pro-
ceeded on the same day to operate in the following-
manner : The patient being placed on the oper-
ating table and having been brought fully under the
influence of chloroform, an assistant grasped the leg
firmly with both hands just above the ankle, while
I held the foot in my left hand. With a strong
scalpel I carried my first incision from just in front
of the external malleolus down, across the sole of
the foot and up on the opposite side, to a point
about a quarter of an inch anterior to the inner
malleolus, cutting down to the bone and dividing all
the tissues, as far as possible, with a single stroke of
the knife. Another firm sweep of the knife above,
from one malleolus to the other, giving a semilunar
shape to the flap with the curve downwards, opened
the tibio-tarsal articulation. A narrow-bladed knife
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153
now divided the lateral ligaments and opened the
joint freely, so that the astragalus was easily forced
out of position by depressing the foot. A few more
touches of the knife to ligaments and cartilages
cleared the way so that I could place the saw be-
hind the astragalus upon the os calcis, with the foot
still strongly flexed downwards. A section of this
bone was now made, beginning just in front of the
tendo-achillis and following the lines of the first
incision downwards and outwards. All the connec-
tions having been thus severed, the mass was now
removed. One artery, the anterior tibial, was liga-
tured, but there had been only a slight hemorrhage
from the operation, which had been executed with
great rapidity. On bringing the parts into apposi-
tion, I found that the tension from the tendo-
achillis was so great that I at once divided it by the
ordinary operation of tenotomy, and found, to my
gratification, that all strain on the flap was instantly
relieved. It occurred to me that, instead of sawing
off the projecting heads of the two malleoli, I might,
by slightly gouging their internal facets, fit the por-
tion of the os calcis contained in the flap between
the two bones. This was accordingly done, and the
appearance of the stump was materially improved.
The sutures were now inserted, a light dressing, of
lint spread with simple cerate, applied to the part,
and over this a bandage. The patient was put to
bed with two pillows under the leg, so as to give it
an elevated position. There was no after treatment
other than changing the dressings once a day.
There was not the slightest evidence of surgical
shock; no perceptible inflammatory fever followed,
except a slight febrile action for a few hours' dura-
tion on the third day. The parts healed by first
intention, and the patient increased so .rapidly in
flesh and strength, that in four weeks from the time
of operation, I failed to recognize her. The stump
proved to be not only shapely in appearance, but
extremely satisfactory for purposes of locomotion.
A Rare Case of Perforating Rupture of the
Perinceum. — In October, 1870, I was suddenly
called one night by Dr. Bowling, to attend a case
of rupture of the perinaeum that had just occurred
in one of his patients. The patient, Mrs. S., 22
years old, had just given birth to her first baby, a
fine, healthy child weighing about eight pounds.
The labor had been extremely rapid, so precipitate
that the child was born before the doctor arrived.
Upon coming to the case the doctor ascertained
that the head had presented, and, upon examining
the patient to see that everything was all right, he
discovered an extensive rupture of the perinaeum,
for which he advised immediate surgical care, and
accordingly called me to the case.
A careful examination revealed a peculiar con-
dition of the parts. The vulva was intact, and so
small that it was evident that the child had not
passed through the natural outlet. To the left side
of the vulva was a large rent, about three inches
long, extending downward and inward, obliquely, to
the anus. The fingers inserted in this laceration
externally, and following it internally, appeared in
the left side of the vagina, about an inch and a-half
from the vulva. The vaginal orifice, the rectum,
anus, and even the sphincter ani, were free from
injury, although the lower part of the rectum, for
about two inches, was laid bare as though by a
careful dissection.
I had read of such cases in the writings of
Velpeau and Coster, but had never before seen an
example of perforation of the perinaeum, for such, in
fact, was the nature of the case. When the
anatomy of the parts is considered, it appears
impossible that a full-sized baby could be born
through a laceration of the perinaeum without any
lesion of the orifice of either the rectum or vagina,
and without an extension of the laceration below
the level of the anus.
As to the cause of the rupture, in the absence of
direct observation I can only hazard an opinion. It
is possible that an abnormally rigid condition of the
vulva might, from its inability to expand, divert the
head, so that the perinaeum would be perforated.
But in this case, although the vulva was rather
small, it was not abnormally so, and so far as the
vaginal orifice was concerned, I failed to discover
any cause for the accident.
We must therefore look for some other cause, and
in the absence of any pelvic deformity, for the pa-
tient, though small, was well formed, we must
conclude that the uterine forces operated in the
wrong direction upon the perinaeum, owing to some
peculiarity in the position of the head. In occipito-
posterior positions of the vertex, we find that the
pressure upon the perinaeum is greater than in the
anterior positions of the occiput, because a greater
power is required to force the occiput forwards, on
account of the extreme flexion of the cervical por-
tion of the spine, which prevents a direct action of
the uterine force. The uterine contractions, in
these positions, force the occiput directly backward,
and the direction is changed by the curve of the
sacrum and coccyx. The expelling force acting
thus indirectly, becomes necessarily augmented
in order to bring the occiput forward, and the force
only becomes direct when the occiput has been
crowded up to the perinaeum. The uterine con-
tractions act with increasing power as the occiput
advances towards the vulva, because the curvature
of the vagina becomes greater from the pressure re-
quired to force the occiput up-hill, as it were, from
the coccyx to the vulva. At this period of the
occipital advance, the rupture or perforation of the
perinaeum is most likely to occur, and hence, I find
the solution of the occurrence in an occipito-posterior
position of the head combined with a precipitate
labor.
The treatment of the case consisted in placing the
parts in apposition, and retaining them there by
three deep, quilled sutures of lead wire, and six
superficial sutures of silver. The patient rapidly
recovered, with no bad symptoms or unpleasant
results.
Ganglion, Hydrocele and Naevus treated by Elec-
trolysis.— In the treatment of some surgical dis-
eases I have made use of electrolysis, from a desire
to study the range of cases to which that method of
treatment was applicable. In ganglion I have used
it once only. The patient, a colored woman, had a
small one on the back of the wrist. I passed one
needle into the cyst, and connected the needle with
the negative pole of the battery, the positive sponge
being applied to the skin over the ganglion. The
current was transmitted from six cells for about two
minutes. The patient complained of the pain so
much that I withdrew the needle, and told her to
come again in a week and I would remove the cyst
in another and less painful way. She came back at
the end of a week to show her wrist. The ganglion
154
The Medical Union,
had disappeared. This occurred two years ago,
and since then, although the result was satisfactory,
I have never resorted to electrolysis in these cases,
because I have never failed to cure the trouble by a
much quicker and less painful method. I follow
the treatment advised by Mr. Skey, which consists
in evacuating the entire contents of the cyst and
bringing the opposite surfaces into close apposition
with each other. The method of operation is as
follows : Bending the hand forwards in order to
tighten the skin over the cyst, a broad-shouldered
lancet is passed vertically into the centre of the
tumor. A lateral movement or partial turn of the
instrument dilates the orifice, so that the contents
freely escape. Now commences a process of knead-
ing, for the purpose of pressing out every particle
of the contents, for the retention of a single drop
will render a failure probable. When an entire
evacuation of the cyst has been accomplished, a firm
and thick compress is strapped down tightly over
the sac and a roller applied. The wound is healed
in about forty-eight hours, and in two days the
dressing may be removed.
I have been so well satisfied with this method that
I have seen no good reason for changing it, although
my experience in the case narrated shows that elec-
trolytic action is also efficacious.
In the treatment of hydrocele, my experience
with electrolysis is extremely satisfactory, so much
so that I believe it to be more efficacious and in
every way better than the ordinary methods. It
occasionally fails, but the proportion of failures is
small as compared with the results of the usual
treatment in these cases. In seventeen cases I have
had but three failures, and these occurred in patients
who had already been treated unsuccessfully by
other methods, although, for that matter, nearly all
the others, on whom the electrolysis had a more
happy result, had been previously subjected to
operations of various kinds without any permanent
benefit. As regards the method of using the bat-
tery in these cases, I have in ten cases connected
the needles with the negative pole, completing the
circuit with the positive sponge applied externally.
In seven cases I have inserted needles connected
with both poles. I have generally made two or
three applications with a small number of cells, but
have in six cases found one application sufficient. I
prefer to allow at least four days to intervene be-
tween the applications, as the process of absorption
is not always rapid, although I have in one case
entirely dispersed a large hydrocele of long stand-
ing in twenty-four hours, another in two days, and
a majority of the cases within two weeks. It is only
exceptionally that I find it necessary to use more
than ten or twelve cells, although there is not the
slightest danger attending the use of a full battery.
My reason for using a comparatively small number
of cells is, that the operation of electrolysis is de-
cidedly a painful one, so that if more than twelve
cells are used, anaesthesia is generally required, and
therefore, to avoid the necessity of giving ether or
chloroform, I prefer to repeat the less painful and
less effectual operation. Sometimes, however, I
have found the current from six cells giving more
pain than the patient could bear, and in other cases
I have had the needles from both poles buried deep
in a tumor and the current from a full battery de-
composing the tissues so rapidly as to give a sound
as though oysters were frying within, " sizzling," as
the term goes, without a complaint from the patient,
and actually without severe pain. My general rule
is to make the current as strong as the patient can
bear without anaesthesia. If no effect is perceptible
within four days, a stronger current, of from twenty
to forty cells, is used, while the patient is under an
anaesthetic. The first time I tried the effects of
electrolysis upon a naevus was in the case of a little
child, a patient of Dr Bowen, of Jersey City. I
had previously used pressure, had ligatured the
tumor four times, used the seton, the injection of
perchloride of iron, and all not only without effect
but evidently with the result of increasing the
growth. Dr. Helmuth saw the case with me, and
also applied the ligature, after Erichsen's method,
with the same result. Finally I used electrolysis,
repeating the application three times within two
weeks, without injury and without benefit.
Since then I have performed electrolysis on seven
bloody tumors, mostly naevi, with happier results.
A small one on a young lady's ear was entirely
removed at one sitting. A large one, resembling
more a cirsoid aneurism, occupying the cheek and
lower lip, was partially cured in three operations,
when my patient was obliged to leave the city, and
since then I have not seen the case. The third
case was a naevus about the size of a walnut, on the
forehead of a child six years old. Two opera-
tions cured it, but the naevoid skin sloughed off,
leaving a slight scar. The fourth and fifth cases
were similar to the third, a scar of small size occur-
ring in each. The sixth case was a small aneurism
of the radial artery, in which I operated as follows :
A tight bandage was first put on, going from the
fingers to just above the elbow. A turniquet was
now so applied to the brachial artery as not to inter-
rupt the venous circulation. An opening was then
made in the bandage so as to expose the aneurism,
which was allowed to become about half full. Nee-
dles were inserted from both poles, and in less than
ten minutes the aneurism was shrivelled up and
hardened by the action of the current. The bandage
was now loosened, the turniquet removed, and a
firm compress placed over the remains of the
aneurism. Three days afterwards I examined the
case and found the cure was complete. The seventh
case was a naevoid growth on the lip. Two appli-
cations failed to cure it, and it was finally excised.
So far as regards the treatment of naevi, I believe
that electrolysis is more generally efficacious than
other methods, and is preferable to any other sin-
gle operation. In other vascular growths a larger
experience is required to form an opinion of its
merits.
Sulphites in Disease. — Dr. Tolli, of Milan,
strongly recommends the use of Sulphites in
zymotic diseases, and claims by their means the
course of eruptive fevers is entirely under control—-
mild cases being rapidly cured, and severe ones
rendered mild. He recommends as a curative,
Sulphite of Magnesia, because it is easier to take
and contains more Sulphurous Acid. As a prophy-
lactic, the Hyposulphite of Soda. He does not
think these salts kill directly the living germs of the
organic poison, but modify the aggregation of the
material components of our own organism, render-
ing it, by their presence, incapable of being acted
upon by these catalytic germs.
The Medical Union.
155
A FEW REMARKS ON HYDROPHOBIA.
By Dr. Schieferdecker.
Hydrophobia (like many other terms, is a medi-
cal misnomer, by Dr. Fuchs more properly called der-
mopneuma tetanus) is a painfulness proceeding from
a place of incubation, which deprives the patient of
all self control, repeats at intervals, drives him to
despair, and is followed by icy shiverings; the reflex-
action on the cerebro-spinal nerves cause in the res-
piratory organs, violent, crampy contractions and
feeling of suffocation. But this is only the finale of
a more or less long-existing diseased condition, in
which the animal lives, and is transferred by it into
other living beings.
The mouth-secretions (mucus and saliva) of the
canine and feline species, which, even in health, vi-
cariate for the skin activity, are, of themselves, of
a very intensely-fermenting acridity,' so that they
can dissolve the hardest animal substances, and be-
come more intensified, in regard to quantity and
quality, by exciting influences, such as fear, mal-
treatment, bad food, want of exercise and social
connections, &c. Wherever this foamy, thick dis-
ease-product is brought in contact with any delicate
or abraded part -of a living being, it becomes a
source of disease-fermentation, the productivity
of which assumes more and more intensity, till the
final symptoms appear. The difference between
wounds from the bite of a mad animal and those
from that of a healthy one is very great; the lat-
ter show all the symptoms of torn wounds, and are
connected with inflammation, &c. ; the former lack
all acute activity.
The victim feels, first, a very unpleasant sensation
of slight, creeping chilliness over his external sur-
face, and shuns any draught of air ; he likes to be
alone, is restless, he changes in appearance, he
emaciates, is defiant; excretions more frequent, &c.
The wound heals quickly, but remains sensitive and
as if something foreign were in it. Cool air, strong
light, and touching anything cold, produce a shud-
der and an unpleasant feeling in the back of the
head, alarming the sufferer. From the healed wound
ascends a distressing sensation to the neck and
chest, compressing the respiration. These symp-
toms increase continually, till the final struggle ar-
rives. The saliva of a hydrophobic human being
does not transfer the disease. The sufferer, if not
killed or cured, dies, while the breathing gets slower
and slower. It is a singular circumstance that this
poison seems to paralyze all reaction and self-defen-
sive activity. Without suppuration or granulation,
some tough albuminous secretion forms a loose,
skin-like covering, which may occasionally open and
discharge a thin, acrid fluid. If we succeed in re-
moving at once the virus, the wound changes to a
normal condition. A touch of the scar sends a
darting stitch to the brain, and causes more or less
oppression in breathing. It is necessary, under such
circumstances, to suspect even the slightest sensa-
tion of pressure in the back of the head and neck.
Whatever brings life to the periphery is soothing
to the patient, and stops the progress of the disease.
The patient becomes afraid to drink on account of
the difficulty of swallowing fluids, in consequence
of glandular congestion and swelling in the throat.
The physiological reciprocity of the skin and in-
ternal respiratory organs is the most striking feature
expressed in this disease. The virus, step by step,
paralyzes the surface, and in the same ratio the res-
piration and oxygenation of the blood is impeded;
the blood remains more and more venous, and
filled with excretory matter ; it becomes unfit to
sustain the normal metamorphosis.
The indications for cure are the following, accord-
ing to Fuchs, who has treated sixty-eight cases of
rabies successfully :
1 . Prevention of the influence of the hydrophobic
virus upon the organic texture and fluids in the in-
jured part.
2. Confinement and removal of the effect of the
poison after it has become active in fermentation,
shutting up the virus where it entered.
3. Restoration of the activity of the skin, and re-
moval of its torpor and peculiar sensitiveness.
4. Reduction of the violence which threatens
tetanic effects, to the normal mutuality between the
periphery and central organs.
The patient ought to be put at once into a tepid
bath and carefully rubbed and cleansed, any wound
thoroughly syringed and bandaged, his clothes de-
stroyed. Then placed in bed to perspire, which
perspiration is again to be washed off in a bath.
These proceedings daily to be repeated, till the
wound heals properly. Dr. Fuchs recommends
cauterization of the wounds, and plaster of cantha-
rides over them. Patient must see only cheerful
faces and have no anxiety.
Where the virus has penetrated, Dr. Fuchs gives
a warm bath, keeps the patient in a warm bed and
a warm room. No cauterization, but oiled plaster of
Cantharides applied to the wound. If patient
perspires, the disease is conquered; if he does not,
then Fuchs puts him in a tepid bath in which he,
from time to time, at some distance from the body,
pours a watery solution of Corrosive Sublimate,
under constant stirring of the bathing water, till the
wounds become painful. Such a bath is daily re-
peated with a stronger admixture of the caustic.
With the bathing-water is also to be washed any
wound on the head ; but, of course, with great cau-
tion regarding the eyes, nose, ears, and mouth. This
bath is to be prolonged to 45 minutes if other symp-
toms will permit. All wounds to be covered with
the plaster of Canth. Finally, a continuous perspi-
ration is attained. Dr. Fuchs asserts that the regu-
larity and form of the mercurial crises depends on
the regularity and perseverance of the use of the
baths — on keeping the patient warm in a well- venti-
lated room. In case the patient is threatened with
an attack, Fuchs acts yet more energetically; he
puts the sufferer at once in a warm bath, so far sat-
urated with corrosive sublimate that the anus and
sexual organs are painfully affected. To prevent
too violent impressions, Dr. Fuchs adds a decoct,
of two ounces of Belladonna, which enables the pa-
tient to stay in the bath for half an hour. These
baths are then repeated morning and evening, till
better. Always oiled plaster of Canth. on the sore
places.
The only case I have treated, which is described
in Watercure in America, I have solely handled
with half-baths, compresses, rubbing and perspira-
tion.
[Dr. Schieferdecker's article was written for this Journal. Since it
was in type, it has appeared in the columns of a daily paper, but
without our knowledge.]
156
The Medical Union.
A CASE OF OBSTINATE CONSTIPATION.
By obstinate constipation we mean a constipa-
tion that not only resists the most powerful purga-
tive and drastic remedies, but often leads to very
serious complications. These cases show us, more
than any others, how little we can rely on the theo-
ries so much vaunted in the writings of allopathic
authorities — how incomplete are the ordinary means
used by them to meet the exigencies of the disease.
What is worse than all, the fewer resources allo-
pathy offers to its follower, the heavier become the
doses upon which he lays his desperate hands. He
cannot possibly understand how a colon or a rectum
can become so obstinate as to resist the power of
Aloes, the acridity of Jalap, or the heavy pressure
of Croton Oil — and yet he finds it is so. This makes
him only more desperate. He now adds two drops
of Croton Oil instead of one to his mixture of Castor
Oil, regardless of the fact that the pathological pro-
cesses, as well as the true cause of the condition of
the bowels are not only invisible, but incomprehen-
sible to him as a pure anomaly. In proportion as
he becomes thus helpless, he becomes more active
with the means at his disposal. His watchword is,
"I must succeed if it takes life!" Every new at-
tempt followed by a new failure gives him the ap-
pearance of a desperate duellist, until his ultimatum
comes — "kill or cure !"
Here we see the advantages of Homoeopathy. In
cases like this its specific action soon leads to an
early solution of the difficulty. And, even when in
the first attempts to grapple with the disease an er-
ror has been committed, no injury has been done
by its action, which can certainly not be said of the
drastic remedies of the old school, for they not un-
frequently lead to inflammation, and even gangrene ;
and, in their least objectionable results, to a subse-
quent constipation as a secondary action of the
remedies employed. * * * *
The case which I now relate is one which pecu-
liarly illustrates the truth of our law of " similia sim-
ilibus curantur" for the two remedies by means of
which the cure was completed are such as have the
well-established primary action of causing the most
obstinate constipation.
Mrs. H., of W., wrote April 9th, 1871, when ask-
ing for medical advice and relief: "I am fifty-one
years old ; change of life has not taken place yet,
nor do I feel any inconvenience from it. I am of
sanguine temperament. For the last seven years I
have had no passage except by the aid of injections,
and three or four were generally necessary to pro-
duce an evacuation. The physicians said that in-
durated feces had accumulated in the colon and
rectum ; that in the right side, was, so far as I could
judge, an accumulation about four inches long, and
resembled in feeling, a thick sausage. Night be-
fore last, there was a sensation as though the indu-
rated mass had broken in pieces. I seemed to feel
one piece after another give way, and it produced a
sensation as though the bowel was filled with the
debris ; I felt sick and had severe headache. Since
then I have constantly used injections of Chamo-
mile tea, Oil and Oat-meal gruel, the last being the
most soothing. Yesterday, I passed with great pain
and suffering, little particles as hard as stone. To-
day not a sign of a passage, and all injections are re-
tained. The hard mass within me has lost its sharp
outline, and occasionally I feel pretty well. For
some time I have not been able to sleep at all."
It was some little time after receiving this letter
before I could see the patient, who lived thirty miles
from my residence. In the meantime I sent her
Lycopodium, and afterwards Sepia. On my first
call I found that Mrs. H. had much improved in her
general health, but the constipation continued as
before. Induced by the recommendations of Schroe-
der, I gave Aloes, as an efficacious remedy in simi-
lar cases, but I soon had cause to regret it.
My patient wrote, " Until Tuesday evening I
very much regretted having received such a guest
into my body; since then it has quieted down. It
behaved like a forward, inquisitive woman, who
poked her nose into every corner, pinching and nip-
ping everywhere, and after all, without any other
results than wind and water. I must say that Cas-
tor Oil goes about for a little while like a roaring
lion and then subsides; but Aloes never knows
when to stop. But I must confess that salts deserve
the palm over all, for they combine the peculiari-
ties of each. I need not say anything as regards
my present health and symptoms, for both are such
as Aloes would make them. I suffered all yesterday
from chills, uncomfortable feeling, heaviness in the
limbs and abdomen. The pinching in the right
side (in the spot which you examined), has nearly
ceased. I think, my dear Doctor, we had better
adhere strictly to homoeopathy." Her instinctive
preference for a purely homoeopathic treatment did
not deceive her. Until the first of May she was
placed upon Nux-vomica, Ignatia and Graphites,
but could not get along entirely without injections.
On the 10th of May, she writes, " I am perfectly
well ; everything is in the best condition, only the
passages are dark as yet. Mineral, waters which
have been recommended to me, I have not taken,
because from actual experience, I have no confi-
dence in them. Homoeopathy is the only thing
that can or will help me."
On the 17th of May, she writes, "Again I am
happy to tell you everything goes well, only one
symptom remaining, viz. : when I turn quickly
round I am attacked with dizziness and sudden
weakness. "
Finally, on the 31st of May, she writes, " Let me
finish by expressing to you my sincere gratitude for
your advice and treatment, so successful in my case.
And in reply to your question, as to what medicine
has been of final use to me, let me say that it was
the drops you ordered for me from Leipsic. I had
only taken four times out of each little vial when
a total change in the condition of my bowels and
health took place."
These drops which I prescribed for her were,
Opium 6, and Plumbum 6, one drop every morn-
ing before breakfast in alternation; and as has
been already seen in her letter, four drops of each
were sufficient to work a cure, so that in eight days
it was complete. In conclusion, let me say that it
is only necessary to compare the symptoms of these
two remedies as described in Jahr, to perceive their
perfect adaptation to the case in hand upon the
principle of "similia similibus curantur."
Physician to the Sultan. — Dr. Mary L.
Wadsworth, a graduate of Mount Holyoke Semi-
nary and a former practitioner in Springfield, Mass.,
is now family physician to the Sultan of Turkey.
The Medical Union.
157
The Medical Union
A MONTHLY JOURNAL
Of Medicine, Surgery, and the Collateral Sciences.
Editors :
EGBERT GUERNSEY, M.D. CHARLES E. BLUMENTHAL, M.D.LL.D.
JOHN C. MINOR, M.D. ALBERT E. SUMNER, M.D.
H. M. PAINE, M.D.
Published on the First of each Month, by
C. T. HURLBURT, 898 Broadway, New York.
NEW YORK, JULY, 1873.
"A regular medical education furnishes the only presumptive
evidence of professional abilities and acquirements, and ought to be
the only acknowledged right of an individual to the exercise and
honors of his profession." Code of Medical Ethics, Amer. Med.
Ass., Art. iv, Sec. i.
NEW YORK STATE HOMEOPATHIC INSANE
" ASYLUM.
At the annual meeting of the Trustees of this
asylum, held June 19th, Fletcher Harper, Jr., was
elected President; Grinnel Burt, Vice-President;
Peter S. Hoe, Treasurer; M. D. Stivers, Secretary.
Dr. Henry R. Stiles, Secretary of the Bureau of
Sanitary Inspection of New York, was appointed
Medical Superintendent.
No better appointment than Dr. Stiles for Super-
intendent could possibly have been made. His
homoeopathic orthodoxy is unquestioned, and his
rare executive abilities as a medical officer have been
fully tested in connection with our own Sanitary
Board, where he has won the respect, esteem, and
hearty approval of all his colleagues.
He is 41 years old; had classical education at N.
Y. University Grammar School, and at N. Y. Uni-
versity, and at Williams College. Studied Medi-
cine at Medical Department of N. Y. University —
graduated 1855. Also same year, graduated at N.
Y. Ophthalmic Hospital. Practised in New York
City; Galena, 111.; Brooklyn, N. Y., and Wood-
bridge, N. J. From 1863 to 1866, was one of origi-
nators and first librarian of Long Island Historical
Society, at Brooklyn. In 1868, became connected
with Brooklyn Bureau of Metropolitan Board of
Health, and was chief clerk in that office till June
1870, when the Commissions were broken up by
legislative act. Was then appointed Medical Health
Inspector in the New York City Board of Health,
and served as such (in 4th, 6th and 2d wards) until
the creation of the new board in June, 1873. Pass-
ed the Civil Service examination of the new board
with honor, and was re-appointed Sanitary Inspec-
tor June 17, 1873. Author Hist. Windsor, Ct.
2 vols., 8vo. ; Brooklyn, N. Y., 3 vols., 8vo., and
several other important works.
President of N. Y. Geneal and Biograph. Socie-
ty, from its beginning, 1869, until January 1st, 1873.
Was one of its organizers.
Rec. Secretary of American Ethnological Society ,
for some eight years past.
One of the organizers and first Rec. Secretary of
the American Anthropological Institute.
Corresponding and honorary member of the
N. Y. Historical Society, the American Philological
Society, and many other State and local historical
and other learned societies.
Was one of the organizers and first members of
the Public Health Association of N. Y. City, in
1872.
Member of Kings County Homosopathic Medical
Society.
Under Dr. Stiles we look for a wise and judicious
administration of the affairs of the institution.
The central executive building is now nearly com-
pleted and presents an extremely beautiful appear-
ance. It is hoped that it will be ready for the re-
ception of patients in September or October. The
building committee have instructions to commence
at once the excavation for an additional building of
the same size as the present one, to be three stories
high, and to cost about seventy-five thousand dol-
lars.
Under the present able management, there is no
reason why this institution should not, when com-
pleted, at once take rank, in the successful and scien-
tific treatment of the insane, among the first in the
world. Hahnemann, as superintendent of an insane
asylum, was among the first to suggest and carry
into practice the idea that the insane should not be
treated as heretofore, like wild beasts, but that the
law of kindness would reach even them and bring
back to sanity and usefulness those who had been
considered hopeless. It is right and proper that
one of the State institutions should be placed under
the direction and management of our school. If we
fail it will not be the fault of the State, which has
contributed its funds with a liberal hand, but of our-
selves. But we shall not fail. What enlightened
science can do for those bereft of reason will be
done, and no effort will be spared by trustees or medi-
cal officers to make this institution second to none
in the successful treatment of the insane.
We earnestly call attention of the trustees to the
necessity of making some provision for the reception
and treatment of the inebriate. This is a form of
insanity not recognized by the laws of the State, be-
cause it is the result of alcoholism, and would sub-
side with the discontinuance of the poison. And
yet it may become, and often is, a distinct species
of insanity, holding its victim in a grasp he has no
i58
The Medical Union.
power to break, struggle as he will. He yields be-
cause he cannot help it, because his power of resist-
ance is paralyzed. His promises are given only to
be broken, and his firmest resolutions are swept away
like cobwebs before the fearful cravings of his dis-
ease. What is this man's promise worth ? what good
does it do to appeal to his honor? It is evident that
this disease requires peculiar treatment and peculiar
companionship. The constant fellowship with the
ordinary forms of insanity, with those whose minds
are all out of tune, would result in positive harm.
They should have a building devoted entirely to
them, constructed and managed with an eye to their
wants. They should have their reading-room and
library, and facilities for general amusement and
physical development, but they should be watched
as closely, as carefully as those in the other depart-
ments of the insane. It should be an absolute im-
possibility for them to obtain alcoholic stimulants
in any form or in any way whatever, except directed
by the medical attendant to save life. If there is
no law on our statute books, one should be passed
whereby an inebriate could be committed to an in-
stitution of this kind, and be as distinctly and com-
pletely under the control of the medical officers as
are the other forms of insanity.
We have no institution which meets this require-
ment. They are all but little more than chartered
boarding houses, where the inebriate can stay as
long as he chooses, and in reality, do pretty much
as he likes. In the real work of saving the inebri-
ate they are comparatively worthless. We trust the
trustees will look carefully at this matter, and as
soon as their funds will permit, make some provision
for this class, so much neglected, and yet who could
easily be saved.
t£he Tftebical Union itlinic*
Diabetes. — Mrs. T., aet. 65, consulted me, about
January 1st, in relation to a difficulty from which
she had been suffering for a considerable period.
The patient was a lady of full habit and lymphatic
temperament, and. the history of her case presented
the following symptoms : Malaise and general de-
bility, excessive urination, increase of the appetite,
tendency to loss of flesh, costiveness of the bowels,
with dry, hard evacuations. On examination of
the urine, by Fehling's & Tronmer's test, sugar was
found in considerable quantities, establishing the
diagnosis of diabetes mellitus. Restriction was at
once placed on the diet, all starchy food being in-
terdicted and the patient only allowed meat, eggs,
bran bread, and butter. At the same time recourse
was had to the internal administration of Nitrate
of Uranium and Phos. Acid dil., the former being
given in the first centes trituration, three grains
every three hours, and the latter in five-drop doses
three times a day. Under this treatment, in the
course of a fortnight, a marked amelioration in the
symptoms was observed, and the urine presented a
considerable diminution in the amount of sugar
held in solution.
May i$t/t. — Between four and five months from
the time treatment was begun, a specimen of urine
was brought which was entirely free from sugar,
the quantity passed much reduced, and the
general health greatly improved. June 10th. — An-
other specimen was brought which still remained
free of sugar.
Though a. permanent cure can not positively be
declared, yet the success of the remedies made use
of certainly entitles them to a great degree of con-
fidence.
Especial importance attaches to the Nit. Uran.,
as probably the most efficacious remedy we pos-
sess in the treatment of the disease in question.
Henry F. Aten, M. D.
34 Hanson Place, Brooklyn.
Two Cases from Practice. — I was called to see a
lady suffering intensely with a boring pain in the
region of the liver. After the use of several reme-
dies without avail, I gave her a dose of Ammonium
Carb., which was followed by immediate relief.
She has remained well without any return of the
pain. The selection of the remedy was in strict ac-
cordance with the Materia Medica, as the kind of
pain described is to be found in its provings. Her
symptoms, otherwise, were similar to those of
persons I have seen suffering with congestion of the
liver.
A patient consulted me for an affection of the
eyes consequent upon small pox. Finding her
weak and thin in flesh, with a view the more speedily
to cure the ophthalmic trouble, I directed my atten-
tion to the improvement of her general health.
Upon inquiry, I found her suffering with diarrhoea,
piles, and colic. The colic had been so severe as to
require the attention of a physician the entire
night, without affording any relief. In addition to
these symptoms, she complained of flushed face
and headache about four o'clock every afternoon.
I prescribed Cactus, one dose a day in the afternoon,
with the request to call upon me in three days. To
my surprise she reported herself entirely relieved
of every vestige of the diseases of which she had
complained. As she had no return of diarrhoea,
colic, or piles, I had no occasion to continue the
remedy. I should add the piles were of the fluent
kind. T. Haughton, M. D.
June 10, 1873.
Auscultation of Chest in Organic Brain
Disease. — Dr. Brown Sequard advises frequent
examinations of the chest in cases of organic brain
disease. He cites cases where injury of the brain
will produce emphysema, pneumonia, and diseases
of the liver, stomach, and kidneys. Pneumonia is
often produced when the injury is on the right side.
He refers to 280 tubercular cases in which the
origin of the disease was traced to inflammation of
the brain, showing it not to be of accidental occur-
rence. His conclusions are, that in animals who
have received brain injury, inflammation of the
lungs may follow. The injury in this manner
causes death. In man the same effect is shown by
actual experiment. The life of man may be saved
after injury to the brain, by early auscultation and
percussion.
The Medical Union.
159
Correspcm&ence*
A LETTER FROM THE SUPERINTENDENT OF
THE INSANE ASYLUM.
The State Homoeopathic Asylum for the
Insane.
Middletown, Orange Co., N. Y., July 6th, 1873.
Friend Sumner: — This is my first day of living
in the new home, and I am still unsettled — boxes and
trunks, etc., around me and bare floors — and so
will be until plasterers, carpenters, and paperers
have done their appointed work. I take the oppor-
tunity afforded by this quiet Sabbath afternoon to
give you the items you needed about the asylum
and myself. Thusly and briefly here are the raw
facts — I've no time to cook 'em :
At present (July, 1873), the first building is rap-
idly hastening to completion — will be ready for oc-
cupation about December 1st. Four stories and
basement; fine brick, with Ohio stone dressings;
basement story of stone off the place, and from
front of building projects a noble tower, affording
(besides several elegant rooms) a fine ftorte cochere,
tank for water, etc. Style of building, Rhenish.
The solidity of edifice gracefully relieved by the
elegant bay-window balconies on each end, and by
the two smaller pinnacles on roof. Architect, Carl
Pfeiffer, of New York City (the architect of the
Roosevelt Hospital), Consulting Architect of the N.
Y. Board of Health. This building shows his most
earnest care to secure all the sanitary improvements
and features which are so important in such an in-
stitution. The heating (by steam) and ventilating
is under the care of Mr. W. Leeds, of New York
City. The contractors for building are Lyon, Fel-
lows & Brown, of New York City. The whole
building, for honest construction, solidity, elegance
of style, &c, cannot be excelled by any similar
asylum. Size, 175 feet by 100 feet. Cost, $115,000.
Within the present month the building of a sec-
ond building, 195 feet long and three stories and
basement, in similar style, though less ornate, will
be commenced, and rushed through with all possi-
ble dispatch. Cost. $75,000.
Both these buildings (two others are also compre-
hended in the plan) are located beautifully on a
farm of 250 acres, one mile to the N. W. of Middle-
town, accessible by pleasant roads. All fuel, heavy
furniture, and stores, are delivered directly at rear
of buildings, by a branch rail-track from the Erie
R. R. Water-supply furnished by the town, from
Monhagen Lake. The location of the asylum con-
fers great credit upon the taste and good sense of
those who chose the spot, both as to its healthful
and picturesque points. The views from the build-
ing are sufficiently extended, enlivening and beauti-
) ful, to produce a cheerful and tranquilizing effect
upon the patients ; and the building now erected is
a conspicuous and creditable ornament to Middle-
town. Truly yours,
H. R. Stiles.
A LETTER FROM VIENNA.
Vienna, May 1st, 1873.
Editors of the Medical Union.
Dear Sirs: — I have for some time been watching
with interest, the results of cold applications for the
control of inflammation after tapping for hydro-
cele. Here, everything that shows any signs of in-
flammation is at once attacked with cold applica-
tions. The case was as follows :
Five years ago, a man, aged about 45, came to
the Clinic with a hydrocele on the right side. This
was tapped and the man went to his business. Soon
after, he returned with a smaller one on the left side,
which was treated like the first. From that time
nothing was heard of the man until the latter part
of last December, when one of the assistants was
called to see him and learned the following:
The man had attended to his business until a few
days before sending for assistance, at which time
his hydrocele on the right side had become large
enough to be uncomfortable, and he went to a hos-
pital in the ward in which he lived, where it was
again tapped, and, as he said, a fluid injected.
The next day he went about his business with no
uncomfortable feelings, and in the evening went to
the theatre. On returning from the theatre, he said
he felt a smarting and burning in the scrotum,
which was worse next morning, and he consulted
the surgeon who had last treated him, who advised
him to apply a cold compress ; but on noticing that
there was snow on the ground, said he might hurry
the matter along by using the snow instead of water.
The patient was in haste to get well and followed the
advice.
It is needless to say that the inflammation disap-
peared at once ; and I might add, that the scrotum
went with it. He was at once brought to the gene-
ral hospital, and when I saw him, which was a few
days after his arrival, the scrotum, or what was left
of it was a mass of suppuration. This continued
until the scrotum and most of the perineum had
sloughed away, and the urethra was laid bare. The
general health of the patient began to fail from the
first; and at this stage he was little more than a
skeleton. The stench from the suppurating surface
was almost unendurable, and Carbolic acid was vig-
orously applied as a disinfectant only, as a belief in
its virtues beyond this point, is not entertained here.
The only treatment beside the Carbolic acid, was
the removal of decayed tissue, cleansing of the sur-
face, and the administration of wine. There was no
appetite, and little or nothing was eaten.
After the case had been given up as hopeless, and
preparations were being made for an autopsy, the
sloughing stopped and the patient began to recover,
gaining gradually from that time to the present.
He is now looking quite fleshy and well, and a
greater part of the scrotum is restored. The hydro-
cele returned on the right side, and was tapped
near the attachment of the cord.
H. R. Cole.
Dr. jARVlS,'in a paper before the Social Science
Association, on the influence of sex in crime, shows
from statistics that while the crimes of males were
against persons and property, in two instances out
of three ; the crimes of females were sensual and
against themselves in the ratio of seventy per cent.
i6o
The Medical Union.
{transactions of Societies.
ALBANY COUNTY HOMOEOPATHIC MEDICAL
SOCIETY.
Dr. Paine called attention to the recent adoption
of a change in the form of the by-laws of the
Massachusetts State Homoeopathic Medical Society,
regarding the objects of the society and the admis-
sion of members. He urged the adoption of a sim-
ilar form, and gave notice that he would propose
such a change at some future meeting. He also
presented the following resolutions :
Whereas, Adequate medical knowledge and a
compliance with legal requirements should constitute
the basis on which associations of medical men
should be formed, rather than an opinion regarding
the therapeutical action of medicines, therefore,
Resolved, That we hail with satisfaction the an-
nouncement that the Massachusetts Homoeopathic
Medical Society has adopted the following article in
its by-laws :
" This Society demands for itself absolute liberty
in science, and hence requires of its applicants for
membership no creed or confession of belief, but
only an expression of a willingness to act for the
furtherance of its objects."
Resolved, That the Albany County Homoeopathic
Medical Society also hereby declares, that no creed
or confession of medical belief shall be required of
educated and legally-qualified physicians who may
apply for membership.
The changes proposed by Dr. Paine were the fol-
lowing, to erase the following words from the pre-
amble : "Believing in the homoeopathic maxim,
similia similibus curantur" Also change the first
and fifth articles as follows :
Article I.
This association shall be known as the Homoeo-
pathic Medical Society of the County of Albany,
and its object shall be the advancement of the
science of medicine as expressed in the following
statement : The society demands for itself absolute
liberty in science, and hence requires of its appli-
cants for membership no creed or confession of
medical belief, but only the expression of a willing-
ness to act for the furtherance of its declared objects
The objects of this society and of its members
are hereby declared to be, ist: The development
of the materia medica by the proving of drugs
upon the systems of men and animals. 2d. The
improvement of methods of administering medi-
cines thus proved, to the sick, in accordance with
the formula, siinilia similibus curantur. 3d. The
encouragement of special studies and reports de-
signed to improve its members in all of the depart-
ments of medical science.
Article V.
Any regularly-licensed physician who has com-
plied with the requisites of the laws of the State
may be elected a member of this society, by the
votes of a majority of the members present at any
regular meeting ; but no persons shall be entitled
to the privileges of membership until he shall have
signed the constitution and paid the initiation fee.
MEDICO-LEGAL SOCIETY.
Mr. David Dudley Field read a very able
paper, April 24th, before a critical audience of the
New York Medico-Legal Society, corner of Twenty-
third street and Fourth avenue. Mr. Field began
by asserting that he would not consider the medical
aspects of the question, but would simply treat of
emotional insanity as it concerned the commission
of crime and its punishment. He believed that it
was not a question of right or wrong whether a
crime had been committed or not ; it was rather one
of law. What was wrong a century ago was right
to-day, and what was right to-day was wrong a cen-
tury ago. The distinction between these two quali-
ties was the result of education. Why was crime
punished ? Not to avenge, not as a mere chastise-
ment for an offence ; but punishment was inflicted
to deter, and when it ceased to have that influence
it should cease altogether. It was society demand-
ing security.
Certain exigencies permitted certain punish-
ments for the public good. If three men were at sea
in a small, open boat, and one should labor against
the life interests of the other two, it would be per-
fectly right and proper that the offender should be
launched into the sea. Having shown that punish-
ment was not to be guided by mere sentimentality,
Mr. Field proceeded to criticise severely the charges
of the judges in some of the most famous of
modern criminal cases, where the plea of emotional
insanity has been put forward in justification of
crime, and successfully maintained. Huntington's
was a case in point, and in the trial of Sickles for
the murder of Key the judge charged that the jury
should acquit if they found that the prisoner was in
such a mental state at the time he shot the victim
that that he did not know that he was committing a
crime ; in other words, if the knowledge that Key
had debauched his wife had so affected his mind
that he did not consider the quality of his moral ac-
tion in the shooting, then he was to be holden guilt-
less— that is, if Sickles thought he was doing a good
thing, it was all right, and the jury must not con-
vict. Was there ever a greater absurdity? He
also mentioned the case of Wagner, and ridiculed
the charge in the case of Cole. In this case the
judge charged that if the jury should find the
reason of the prisoner was dethroned by the in-
telligence of his wife's defilement, so that he was
incapable of knowing that he was committing a
legal and moral wrong, then they should acquit.
Recorder Hackett, in the McFarland case, had
made a charge equally absurd. The Recorder
charged that not only must the prisoner know that
he was committing an offence against the statute,
but that he is morally guilty as well, in order to con-
stitute murder; in other words, again, " I think
this is a good thing to kill Richardson, therefore,
I'll do it." Judge Smith had also taken the same
ground, and only two months ago Judge Brady, in
the case of Scannell, charges that the prisoner must
have been convinced of doing a moral wrong in or-
der to have been guilty of murder. The poor man
thought he was avenging the death of the brother.
Mr. Field thought that all of these crimes should be
punished, because they were absolute offences
against the law, and as punishment was to deter, its
operation in these cases was necessary for security.
Insanity had been defined by many able men, yet
The Medical Union.
161
all differed. He would venture to state what in-
sanity should be considered in law.
First — Was the prisoner at the time of the com-
mission of his crime capable of refraining from its
commission ?
Second — Did he refrain from its commission ?
Insanity he considered as that manifestation in
a person showing that the process of his brain was
at variance with the average human brain. Insanity,
he said, was divided into —
First — Perceptional.
Second — Overthrow of the reason, or intellectual
insanity.
Third — Emotional.
Fourth — Volitional.
Emotional insanity was manifested by impulse ;
perceptional by hallucinations, while intellectual
and volitional insanity were allied to each other.
Mr. Field, after an exhaustive discussion of these
forms of insanity, summed up his papers with these
conclusions :
First — That children and idiots are not holden to
criminal responsibility.
Second — That mental unsoundness may excuse
crime when the will becomes the slave of defective
reason.
Third — Insanity excusing crime must be shown
by experts to be a brain disease.
Fourth — Neither emotional nor perceptional in-
sanity is an excuse in itself for crime.
Fifth — All persons declared insane should be
put in lunatic asylums until their restoration to
health.
Sixth — The punishment should be graded to suit
the quality of the crime and the intent and relative
guilt of the criminal.
THE RETIREMENT OF DR. PAINE
FROM OFFICE OF SECRETARY OF THE HOMOEO-
PATHIC MEDICAL SOCIETY OF THE STATE OF
NEW YORK.
We have already spoken of the retirement of Dr.
H. M. Paine from the office of Secretary of tne
Homoeopathic Medical Society of the State of New
York. We copy the following communication from
the Medical Investigator. The occasion gives the
writer an opportunity to speak of Dr Paine's ser-
vices in the cause of medical progress in this State.
" To the Editor of the Medical Investigator :
"The retirement of Dr. H. M. Paine from the office
of Secretary of the Homoeopathic Medical Society
of the State of New York is an event which should
not be allowed to pass unnoticed. As the writer
believes, to no man now living is so justly due the
title of "The Homoeopathic Organizer" as to Dr.
Paine.
"Immediately after the passage of the law of April
13th, 1857, authorizing the organization of Homoeo-
pathic County Societies in the State of New York,
Dr. Paine commenced an attempt to awaken an
interest on the subject of Homoeopathic organiza-
tions in this, as well as in other States. How far his
untiring efforts have been successful the sequel will
show.
"On the 20th of October, 1857, the Homoeopathic
Medical Society of Oneida County was organized in
the city of Utica, and Dr. Paine was present at that
meeting. This was the first county society actually
organized under the new law, although preliminary
meetings for that purpose had been held in the coun-
ties of New York and Kings at a somewhat earlier
date. From this time forward, a period of more
than fifteen years, Dr. Paine has labored unceasingly
to perfect the organization of trie Homoeopathic pro-
fession in the State of New York, and his influence
and advice have contributed not a little to arousing
a spirit of organization in other States.
" At a special meeting of the Oneida County Medi-
cal Society, December 6th, 1859, Dr. Paine read an
elaborate paper on "The importance of immedi-
ately organizing State and County Societies," Trans.
Horn. Med. Soc. of State of New York, vol. 6, p.
543. There were then only seven county societies
in the State of New York. There are now societies
in about forty counties. At the meeting of June
1 8th, 1 86 1, he presented a report embodying a cir-
cular to the Homoeopathic physicians of the State,
which closed as follows : ' We believe it to be of
vital importance in its influence upon the future
prosperity and position of Homcepathy in this State.
The benefits of organization are obviously as great,
as really needed, and as useful to us as to Allopathic
physicians. By it we ascertain the number of edu-
cated and legally qualified physicians of our school,
conform to the statutory enactments of the State,
secure concerted action in the improvement of the
Materia Medica, and facilitate the diffusion of prac-
tical knowledge among the members of the profes-
sion.' Vol. 6 of Trans., p. 566. At the same
meeting he also presented the form of an act of
incorporation of the State Society, and on motion
of Dr. L. B. Wells, the following resolution was
adopted :
"Resolved, That the Oneida County Homoeopathic
Medical Society approves of the act of incorpora-
tion presented by Dr. H. M. Paine, and would res-
pectfully refer it to the committee appointed at the
last meeting of the State Homoeopathic Medical
Society, with the request that earnest and untiring
effort be made to secure its adoption by the next
Legislature of the State. Trans., vol. 6, p. 561.
"This act of incorporation was passed by the Legis-
lature April 17th, 1862, and the Society was legally
organized under it May 6th, 1862. Trans., vol. 1,
p. 19. The honor of having inaugurated the move-
ment for the purpose of securing the legal right to
organize County and State Homoeopathic Medical
Associations belongs to the Homoeopathic Medical
Society of Northern New York, as appears by the
following paragraph from a letter by Dr. Cornell :
" At a semi-annual meeting held in July, 1856, a
committee was appointed to petition the Legislature
to legalize the Homoeopathic practice in this State,
by authorizing the formation of Homoeopathic
County Medical Societies, having equal legal privi-
leges and immunities extended to similar Allopathic
associations. Petitions were circulated and numer-
ously signed, the assistance of the members of the
Senate and Assembly from each of the counties
within the jurisdiction of the Society was solicited,
and by much earnest effort the passage of the act
was secured April 13th, 1857. Trans., vol. \,p. 33.
But the credit of urging the matter to a successful
termination is due to the Oneida County Medical
Society, and chiefly to Dr. Paine. Up to April,
1865, Dr. Paine resided at Clinton, in Oneida
l62
The Medical Union.
County, New York, about nine miles from Utica.
As a proof of his untiring devotion to the subject of
Homoeopathic organization, the writer would men-
tion the fact that between the years 1857 and 1865 it
was no uncommon event for him to be awakened about
midnight — alike in summer or the depth of winter —
by the arrival of Dr. Paine, who, impressed with
the importance of some new movement for the
cause of organization, had driven from Clinton late
in the evening to confer with him upon the subject
during the middle hours of the night, in order to
return for attendance upon his patients with the
breaking of the day.
" Any physician who resided in the State of New
York during those memorable years will readily
recall the frequent and urgent letters which he re-
ceived from Dr. Paine upon the subject of organiza-
tion. I doubt if any escaped such a missive for a
single week, and I state the simple truth when I aver
that I have often received three per diem. It is a
matter of record that between September 1st and
December 1st, 1861, he mailed 500 circulars and
wrote 300 letters upon this subject. Vol. 6 of Trans.,
p. 564. What Thurlow Weed was to the Whig
party in the politics of the State of. New York, Dr.
Paine has been to the Homoeopathic profession in
medicine. He has made the Homoeopathic Medical
Society of the State of New York the most com-
pletely organized, as it is the largest, State Society
in the United States, and has rendered it the most
effective in point of political and social influence.
Its power for the advancement of the interests of
Homoeopathy is felt in all parts of the civilized
world. Dr. Carroll Dunham, in an article on the
American Institute of Homoeopathy, contained in
Vol. 2 of Trans. N. Y. State Horn. Med. Soc. at p.
390, thus speaks of the efforts of Dr. Paine with
reference to organizing that association on a repre-
sentative basis : ' The necessity and advantage of
thus converting the Institute into a National Repre-
sentative Society was first pointed out by Dr. H. M.
Paine, of Clinton, Oneida County, the indefatigable
Secretary of the New York State Homoeopathic
Medical Society, to whose untiring industry and tal-
ent for organization we owe the establishment, and
very much of the usefulness, of our State Society.'
Of the thoroughness, accuracy and conscientious
fidelity with which he has edited the Transactions of
the Homoeopathic Medical Society of the State of
New York, the ten volumes which will stand upon
the library shelves of thousands of Homoeopathic
physicians, in this and other lands, will for ever
remain as an enduring memorial. Of the labor
required to prepare such a volume for publication,
involving a correspondence with many contributors,
and with the secretaries of various county societies,
the correction of manuscript, the reading of proof,
and the collating and proper arrangement of the
several articles — those who have had no experience
can form no adequate idea. To this work, how-
ever, Dr. Paine has given his continued and most
earnest attention for ten years. Often, for weeks
previous to the meeting of the State Society, when
a volume of the Transactions was at the same time
passing through the press, has he practised all day,
to resume his work upon the Transactions at night,
and only desisted from his labors at the dawn, to
throw himself upon his office lounge, without remov-
ing his clothing, for an hour or two of brief repose
prior to resuming his professional toil of the ensuing
day. In this manner have I known him to pass six
successive weeks. He constantly paid to the person
who assisted him in the preparation of the volumes
a sum greater than that which he received from the
society. 1 need not here dwell at length upon the
enthusiastic zeal and alacrity with which he has ever
enlisted in every movement for the legitimate ad-
vancement of the interest of Homoeopathy, and the
elevation of the standard of medical education, or
upon the energy and vigor with which he has fought
his battles in the long contest with Allopathic bigotry.
The New York State Homoeopathic Asylum for the
Insane, the Albany City Dispensary, the Albany
City Homoeopathic Hospital, and the numerous ap-
propriations for Homoeopathic institutions in the
State of New York, which he had been largely
instrumental in obtaining ; the various bills passed
by the Legislature of that State, within the last ten
years, in favor of Homoeopathy ; the certain defeat
of all those measures brought before the Legisla-
ture in the interest of Allopathic bigotry ; all bear
witness of the sentinel-like fidelity with which he
has stood guard upon the fortress of Homoeopathy in
the State of New York, and while cordially wel-
coming its friends, has made it absolutely impreg-
nable to its foes.
' ' On a larger and national field, the Van Aernam
contest, and its auspicious termination for our
school — of which the pages of the tenth volume of
the Transactions contain the full record — will be an
imperishable testimony of his inflexible opposition
to medical bigotry. Says Dr. Verdi, chairman of
the Committee upon Legislation, in his report to
the American Institute of Homoeopathy, in speak-
ing of the Van Aernam matter, ' The next thing
was an alarm given from the State of New York,
that almost gave me a fit. And you will not be
surprised when I tell you that the man at the rope
of that alarm-bell was no more nor less than my
friend, Dr. H. M. Paine, of Albany. Several homoe-
opathic physicians had been decapitated by a
certain Dr. Van Aernam, late Commissioner of
Pensions. Paine called it murder in the first
degree, and pulled at the alarm-bell, until I, for
one, was denied all rest or respite. Documents of
various sorts poured in on me, and from that time
I never went to look in my post-office box without
one of those yellow envelopes staring me full in the
face. Had I gone three or four times a day, it
would have been the same, the yellow envelope
would have been there. Finally, my friend got
tired of ringing that bell, and what do you think
came next? Why, a telegram from Paine stating
that he and a few friends would meet me at my
office next morning. When I saw that telegram,
I wouldn't have given a penny for the head of Van
Aernam; I knew it was condemned to the block.
True to his word, my friend Paine, the next morn-
ing, February 25th — I shall never forget it —
appeared in a complete suit of armor, not of steel
armor, as of old, but a more modern one, a car-load
of newspapers, acts, resolutions, indignation meet-
ings, protests,' etc. — Trans. Am. Inst, of Horn.
1 87 1, p. 101.
" Dr. Paine has for several years felt that his duty
to his family and to his patients required his resig-
nation of the laborious position of Secretary ; but in
deference to the earnest solicitations of his friends,
he has retained it to the present time. Now, after
the Society has, for ten years of the best part of his
<
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163
professional life, reaped the full benefit ,pf his
sagacious counsels and rare executive abilities, and
received the full measure of his time and talents, he
retires in the enjoyment of the respect and good
wishes of every member of that organization, which
he has carried to the very front rank in effective-
ness, as well in the promotion of medical science as
in protecting the interests of the Homoeopathic pro-
fession from Allopathic intrigue and intolerance.
" That he will continue, as he has hitherto done, to
take an active interest in all legitimate movements
for the advance of our school of practice, we cannot
doubt. The polemical period of Homoeopathy
probably closed with the ousting of Van Aernam,
above referred to ; and it was most fortunate that
Dr. Paine was the Secretary of its Medical Society
in the Empire State during that most important
period. The ten volumes of the New York State
Transactions, edited by Dr. Paine, have annually
contained a complete resume of the progress of
Homoeopathy in all parts of the world, and thus
constitute year-books of facts and statistics, of
incalculable benefit to the profession, but so con-
veniently accessible in no other publication. These
volumes will forever form an armamentarium, well
stocked with polished weapons, from which the
members of our school may hereafter equip them-
selves in any future contest (should any such arise)
with allopathic bigotry.
" Dr. Vincent, of Troy, who is the new Secretary,
will doubtless emulate the bright example of his
distinguished predecessor. w. H. w."
Reuieuis of Boohs.
The Sanitarian : A Monthly Journal. A. N.
Bell, M. D., Editor. A. S. Barnes & Co.,
New York and Chicago, Publishers. Terms,
$3.00 per annum.
This new addition to the medical press is presented
to the public in an attractive form, and the claims
of its prospectus are ably supported by the pages of
the journal. No journal ihas ever before started
out on so broad and rich a field of inquiry, and,
from the two numbers already published, we judge
that the Sanitarian will meet with a genuine success
not only from the acknowledgment of its merit by
the medical profession, but also from the hearty ap-
preciation of its object by an intelligent public. The
following extract from the prospectus will show the
aim of the new journal :
" The purpose of this publication is to so present
the results of the various inquiries which have been,
and which may hereafter be made for the preserva-
tion of health and the expectations of human life,
as to make them most advantageous to the public
and to the medical profession.
" The resources of sanitary science are inexhaust-
ible. It will be a chief object of the Sanitarian to
awaken public attention to the extent of the field,
and to the facts indicating how beneficently it may
be cultivated. This will be done by showing the
amount of ill health and mortality from preventable
causes of disease ; by pointing out the nature of
those causes, and the way in which they operate, by
showing that such causes are removable ; and by
exhibiting improved health, longevity and happiness
as the fruits of their removal.
"The laws of physiology and general pathology
will be kept in view, as the basis of health ; and by
which hygiene constitutes a department of science
which the medical profession can advantageously
share with the public, or apply to individuals accord-
ing to circumstances. The detail of these relations
will involve questions of manifold significance, and
many of them of the utmost importance to human
health.
"The practical questions of State Medicine: the
health of armies and navies, marine hygiene, quar-
antine, civic cleanliness, water supply, drainage and
sewerage. Sanitary architecture : light, space,
warming and ventilation. Climate and domicile :
epidemic, endemic and hereditary diseases. Occu-
pation, exercise and habits, food and beverages, in
all varieties of quality and quantity. In short, what-
ever thing, condition or circumstance is in rapport
with, or antagonistic to, the most perfect culture of
mind and body will be considered legitimate matter
for the Sanitarian to discuss, advocate, condemn
or reject at the bar of health.''''
We commend the Sanitarian to all who would
encourage or pursue the scientific study of hygiene,
and to those also who would profit by the practical
application of the laws of sanitary science.
The Microscope and Microscopical Tech-
nology. By Heinrich Frey, Professor of
Medicine in Zurich, Switzerland. Translated
from the German and edited by GEORGE R.
Cutter, M. D. From the fourth and last Ger-
man edition. New York : William Wood &
Co.
The microscope has become a necessity in every
well-regulated physician's office. Its revelations are
often essential to enable bim to reach a correct di-
agnosis and to suggest the treatment. If he neg-
lects to make use of the immense help which sci-
ence, in its recent discoveries and improvements,
has placed in his hands, he not only fails in his
duty to his patients, but finds himself left far in the
background. Simple as the use of the microscope
may seem, it requires close and careful study and a
thorough discipline of the eye to make its revela-
tions available. Once on the right track, the pa-
tient student finds a new world opening before him,
and is surprised, at each successive step, at some
new beauty or wonderful development. With its
aid the mystery which surrounded many of his
cases is dispelled, and the path is made clear before
him either to relief or permanent cure, or in the
case of organic disease, he is able to mark out its
course and predict its termination.
Notwithstanding the now general use of the mi-
croscope in this country, it was only in the year
1840, when the U. S. Exploring Expedition, under
Commodore Wilkes, was being fitted out, and it
was thought necessary to have a microscope among
the scientific instruments, that not one could be
found among the makers of philosophical and sci-
entific instruments in this country. In this dilem-
ma Dr. Paul Goddard placed his own instrument,
an inferior French microscope, but the best in the
country, at the service of the expedition. This was
but little over thirty years ago, and now the finest
lenses in the world are of American make. In 1847
Charles A. Spencer, of this State, after laborious
and protracted experiments, frequently working
164
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over the furnace for eighteen consecutive hours,
succeeded in constructing a microscope the lenses
of which were of such clearness and power as to at
once place him in the front rank of manufacturers.
On his way to New York he stopped at West Point
and showed the instrument to Prof. Bailey, at that
time the chief of microscopical observers in this
country. It was with this instrument Prof. Bailey
resolved the Navicula Spencerii, noticed in the first
edition of Queckett on the Mici'oscofte, who says on
page 440, speaking of the Navicula Spencerii, "But
an object glass, constructed by a young artist of the
name of Spencer, living in the backwoods, had
shown three sets of lines on it, when other glasses
of equal power, made by English opticians, had en-
tirely failed to define them."
In Queckett's treatise, in the account given of
Ross' discovery of the effect of thin glass covers
upon the correction of an objective, the announce-
ment was made, that " on several occasions the
enormous angle of 135° had been obtained," and
that "1350 is the largest angular pencil that can be
passed through a microscopic object glass." On
Spencer's attention being called to this statement,
he immediately constructed a -pz inch objective hav-
ing an angle of aperture of 1460. In June, 185 1,
the maximum angle of 178° for the -h was ob-
tained, and subsequently the medium and lower
powers were correspondingly improved. The an-
gle of aperture of the % has been increased to 1750
and its defining and resolving powers are such that
its amplifying powers are brought up to twelve hund-
red diameters, without any considerable deteriora-
tion in the sharpness of its images. With it the
19th band ofNobert's test plate has been resolved
by Spencer, with ordinary daylight illumination
and with artificial light.
Mr. I. Grunow came to New Haven, Conn., in
1849, and constructed his first microscope in 1852.
A very valuable improvement made by Grunow
consists in letting the rotary diaphragm into the
upper surface of the stage in such a manner that it
is just below its level, and can be rotated without
disturbing the slide on which the object is placed.
In this way the full optical effect of the diaphragm
is obtained exactly at the point where it is needed.
Mr. Tolles became a pupil of Spencer in 1843,
and in 1856 commenced business for himself. Mr.
Tolles' improvements in the accessories of the mi-
croscope have been numerous and of great value.
His objectives have been among the best ever con-
structed in this country or in Europe. Mr. I. Zent-
mayer, of Philadelphia, has constructed stands,
which, in beauty, of workmanship, convenience and
perfection of detail are equal if not superior to any-
thing made. His No. 1 stand is exceedingly beau-
tiful, but for ordinary work, his No. 2 stand will be
found all that is necessary.
Mr. Wm. Wales, now residing at Fort Lee, N.
J., was a pupil of Smith & Beck's, in London, and
came to this country in 1862. His lenses are now
considered equal if not superior to those of any
other maker in the world. We have one of his 5,
which is infinitely superior to any -g- we have ever
seen.
The three most renowned firms in London are :
Powell & Lealand, Andrew Ross, and Smith, Beck
& Co. But there is no necessity for our students
going abroad for their instruments when they can
be obtained here of a better quality, and, taking
j into consideration the duty, which is 45 per cent.
ad valorem, almost as cheap as they can be im-
ported.
The beginner is fortunate if he can have the ad-
vantage of other instruction in the use of his mi-
croscope than that which can be obtained from
books, but in the absence of this he will find in the
work under notice very careful directions. In his
first effort he will throw all the light he can get on
the field, and find, to his great annoyance, in a
short time, his eyes weeping and tired. Old ob-
servers avoid a brightly illuminated field, finding
with a moderate light the organs of vision are more
protected, and the finest details of the microscopic
image are more distinct. The student should not
allow his enthusiasm for his work to protract his in-
vestigations too much into the night, as the long-
continued use of artificial light will prove injurious
to his eyes.
It is best to commence most observations with
low powers, as you get here a more extended field
of vision, and for ordinary work the low powers
are all that is necessary ; the physician seldom re-
quiring a power higher than the i. With a general
idea of the parts thus obtained, the most minute
points can be resolved by the higher powers if it is
deemed necessary. The instrument should be ex-
amined each time it is used, and the dust which
has settled on the mirror and eye-piece ca/efully
removed by means of a fine camel's-hair brush.
The objectives may be cleaned, after first removing
the dust, with a piece of linen rendered soft by fre-
quent washings or a piece of fine leather. It was
formerly hoped that the microscope might discover
changes in the forms of the blood cells in disease,
and in this way be able to promote pathological
physiology as well as diagnosis. These beautiful
dreams have not in general been fulfilled. How-
ever various its composition may be, the blood pre-
sents the same microscopic appearance. It is also
to a certain extent the case that, even with regard
to the normal life of the blood, a considerable ob-
scurity still prevails, that we have but an extremely
incomplete conception of the new formation and
disappearance of cells.
However, although nothing of importance is to
be perceived in the endosmatic changes in form of
the colored blood cells which have been described
in processes of disease, and just as little in the
shreds of the loosened epithelium of the vessels, the
microscope has, nevertheless, given us an interest-
ing glimpse of two pathological processes of our
fluid ; we mean the so called leucaemia and melanae-
mia. The former coinciding with an increase in
volume of the spleen, and often, at the same time,
of the lymphatic glands, although but seldom caused
by an enlargement of the latter organs alone leads
to a constant increase in the number of colorless
cells in the blood, so that finally the alteration of
the blood no longer remains concealed from the
naked eye. A drop of such blood shows, together
with the colored, a considerable number of colorless
blood corpuscles. This may proceed to such an ex-
tent that to three colored blood corpuscles there will
be one or even two colorless ones, and, in certain t
cases, the number of the latter variety of cells will ^
be greater than that of those containing hematin.
Transitive forms of both kinds of cells may also be
met with.
In malignant forms of intermittent fever, the en-
The Medical Union.
165
larged spleen has been seen to have a blackish ap-
pearance. The microscope shows as a cause of this
change of color, granulated lymphoid cells, often of
considerable extent, and which contain within them
granules of the black pigment. Passing out through
the splenic vein, they become mixed with the blood,
and are seen in this fluid when subjected to micros-
copic examination. In consequence of their size
they produce obstruction in certain capillary dis-
tricts, especially in the brain and liver.
The origin of fresh clots of blood may be ascer-
tained by microscopic analysis. One will be able
to distinguish by their form and size the cells of the
blood of birds from those of human blood. It is
difficult and almost impossible to render a correct
decision in old masses of dried blood.
The microscopic examination of vomited matter
has thus far yielded only relatively slight results
for the purpose of the practical physician. It is in
the examination of the structural form of the tissues
themselves that we obtain the most satisfactory re-
sults. With the history of the case distinctly before
us, the microscopic examination, after death, of the
bones and nerves and various structures of the dis-
eased part casts a flood of light upon the nature of
the malady, and often serves as a guide in the treat-
ment of future cases where like symptoms indicate a
similar disease. The revelations of the microscope
in the living being give us the most satisfactory re-
sults in the examination of urine. By it we trace,
with almost unerring certainty, the condition of the
kidneys and the bladder, detecting not only the
different stages of Bright's disease, but in the chemi-
cal constituents of the urine many of the changes
going on in the great human laboratory.
The physician needs and should avail himself of
all the aids which science places before him, to as-
sist him in his daily work of arresting and prevent-
ing disease. The work under discussion is one of
the best of the kind we have seen. The directions
for the use of the microscope and the preparation
of specimens are excellent, and the pathological de-
scriptions are fully up to the present advanced state
of the science.
Scientific gleanings*
The French Method of Dressing Wounds
by Cotton Wadding. — A new method of dressing
wounds, at present attaining great popularity amongst
French surgeons, is that which is known as the
"pansement ouate," of M. Alphonse Guerin, of the
Hotel Dieu. It consists in the use of large quanti-
ties of cotton wadding, somewhat after the manner
of treating extensive burns by the same material.
About two years ago, toward the close of the war,
and during the day of the Commune, M. Guerin
first put this in practice in the Hopital St. Louis.
The properties which cotton wadding possesses of
filtering the atmosphere, the regular elastic com-
pression and uniform temperature which its applica-
tion induces, were qualities which he thought might
be turned to good account in the treatment of wounds
and other surgical diseases. An attendance of nearly
six months in the hospitals of Paris during the course
of the winter has enabled me to write with some au-
thority on this subject, which well merits the atten-
tion of the profession in this country. The method
is peculiarly applicable to cases of amputation, and
in order to describe the manner of using it, I will
suppose a case of circular amputation at the thigh.
Bleeding being carefully stopped, the ligatures are
cut short, except that of the main artery, which is
allowed to remain of /the usual length. The wound
is then washed with a solution of camphor and alco-
hol, of carbolic acid, or other disinfectant. The
stump being now elevated and the loose integuments
slightly stretched outwards by an assistant, portions
of cotton wadding are inserted so as to completely
fill, without distending, the cavity thus formed.
Several layers of the same material are then applied
over the stump and carried in the form of broad
rollers round the limb as high as the groin or pelvis.
The volume of the whole ought to be at least three
times that of the thigh, or about the circumference
of the patient's waist. A number of bandages are
then carefully applied, the construction being at first
moderate, but afterwards increasing until it is as pow-
erful as the hands of the surgeon can make it. The
limb is noW placed in a horizontal position, supported
by a pillow and allowed to remain so for twenty or
thirty days.
The first thing that strikes the surgeon is, that
the patient, during the whole of this period, is free
from pain, which neither comes on spontaneously,
nor is it induced by the contact of surrounding ob-
jects or by their shock. A peculiar odor is gener-
ally exhaled during the first ten or fifteen days,
which, however, can be destroyed by the use of dis-
infectants applied to the outside of the apparatus.
* * * The temperature averages 10 1.3 F., during
the first twenty- four or forty-eight hours. It then
returns to the normal standard and never rises again.
I recently saw in the service of M. Guerin, the
removal of the dressing, in a case of amputation of
the upper arm, after an application of thirty-two
days. On arriving at the deeper layers of wadding,
they were found to be firmly glued to the integu-
ments in the vicinity of the wound. About half a
wine-glassful of matter came away with the dressing.
It had a peculiar odor, not that of putrescent pus,
but which M. Guerin attributes to the confined se-
baceous secretion. The skin was quite normal,
being quite free from redness, swelling, or any other
sign of diseased action. The end of the bone was
well covered by healthy granulations, as was also the
whole of the traumatic surface ; in fact, there was
only a healthy granulating ulcer with the character-
istic blue margins, showing that the process of cici-
trization was going on. M. Guerin regarded this
case as a good specimen of the ordinary result of
the cotton wadding dressing. It was reapplied for
another period, which he hoped would complete the
cure. Two applications are generally sufficient ; a
few strips of adhesive plaster is all that is necessary
afterwards, if the ulcer is not quite healed.
The dressing is also applicable to other diseases,
such as abscess and sinus, especially when connected
with joints. I saw a case of synovitis of the knee
joint with sinuses treated by M. Guerin. The sinu-
ses were laid freely open, and the apparatus applied.
* * * The result was beautiful; all the incisions
healed, and the knee about the same size as the
healthy one. In these cases it is necessary to apply
the wadding from the toes to the groin; in the upper
extremity, from the fingers to the shoulder.
In having recourse to this method of dressing,
various precautions must be attended to. The pa-
tient, during its application, should be in an apart-
1 66
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merit where the atmosphere is pure, and then carried
back to his own ward. The compression by the
bandages ought to bear on all parts alike, and be,
at the same time, powerful. It is, therefore, neces-
sary occasionally during the first twelve days, to
apply more wadding and bandages, so as .to con-
duce to this end. In amputations at the thigh,
the stump is liable to elevate itself and cause the
bone to protrude, this will be avoided by main-
taining it in the horizontal position. The tempera-
ture must be taken regularly, morning and evening,
as it will give the first indication of any thing going
wrong. Nothing need be apprehended if it remains
normal after the first forty-eight hours.
The advantages contended for by the advocates
of the "pansement ouate," are:
i. Avoidance of the action of the air, which irri-
tates not only by its physical properties, but also by
reason of the minute organized bodies which it holds
in suspension.
2 A compression, firm, elastic, and sustained,
which moderates the afflux of blood, and produces
rigorous immobility of the parts, both in themselves
powerful antiphlogistic agents in the treatment of
wounds.
3. Remarkable diminution and' frequently total
absence of pain.
4. Constant, uniform temperature of the parts ;
also an important agent in the treatment of wounds.
5. The ease with which it is applied, and the
avoidance of the evil consequences of dressing the
wound daily, or every two days.
6. The protection afforded locally, thus facilitat-
ing the transport of the sick, and their dissemina-
tion in crowded hospitals.
Lastly, The statistics of M. Guerin show a very
marked diminution in the mortality of his large
operations since his adoption of this method.— Wal-
ter Reid, M. D., in London Lancet, April 26.
Dr. Lionel S. Beale on the Action of Al-
cohol.— This eminent authority, after an able re-
sume of the subject, sums up as follows :
" 1. In external wounds, and in internal diseases
where alcohol acts beneficially, the good result is,
in part at least, due to the alcohol checking the in-
creased actio7i already established.
"2. Alcohol does not act as food; it does not
nourish tissues. It may diminish waste by altering
the consistence and chemical properties of fluids
and solids. It cuts short the life of rapidly-grow-
ing bioplasm, or causes it to live more slowly, and
thus tends to cause a diseased texture, in which vi-
tal changes are abnormally active, to return to its
normal and much less active condition.
"3. In 'exhausting' diseases alcohol seems to
act partly by diminishing very rapidly the abnor-
mally-increased growth of bioplasm. The quantity
required will depend upon the extent to which the
changes alluded to have proceeded. In extreme
cases half an ounce of brandy, or even more, may
be given for a time (in some cases even for several
days) every half hour ; and there is reason to be-
lieve that in desperate cases life is sometimes saved
by this treatment.
" Practical conclusions. Lastly, I shall venture
to repeat here the conclusions I arrived at many
years ago concerning the great value of the alco-
holic treatment of low fevers and inflammations.
Increased experience has afforded further confirma-
tion of the correctness of the statements made in
the paragraphs below. I do not, of course, refer to
slight cases of fever, pneumonia, etc., in which no
stimulant whatever may be required, but to very
severe cases of disease only.
" I. In what appeared hopeless cases, as much
brandy as the patient could be made to swallow (an
ounce and a half to two ounces in an hour) has been
given for several hours in succession, and then as
much as thirty ounces a day for several days, not
only without producing the slightest intoxication,
vomiting, or headache, but the treatment has been
followed by recovery.
"2. I would adduce the fact that a man not ac-
customed to drink, when suffering from acute rheu-
matism, complicated with pericarditis with effusion,
pneumonia at the base of one lung, and pleurisy on
the opposite side, has taken twenty four ounces of
brandy a day for eleven days, the tongue being moist
and the mind calm during the whole time. While
under this treatment, inflammatory products were
absorbed, and the general state of the patient much
improved.
"3. I have been compelled to give a very weak
child, weighing less than four stone, twelve ounces
of brandy a day for ten days, while suffering from
acute rheumatism, with pericarditis and effusion.
This quantity did not produce the slightest tendency
to intoxication, or exert other than a favorable effect
upon the disease. The patient did not begin to im-
prove until the quantity of brandy, gradually in-
creased, had reached the amount stated.
"4.. I would state that among the general con-
clusions I have reached, after carefully watching
more than one hundred cases of acute disease
treated with large quantities of stimulants, are the
following : That intoxication is not produced ; that
delirium, if it has occurred, ceases, or is prevented
from occurring at all in the course of the case ; that
headache is not occasioned ; that the action of the
skin, kidneys, and bowels goes on freely ; that the
tongue remains moist, or, if dry and brown, often
becomes moist ; that the pulse falls in frequency and
increases in force ; that respiration is not impeded,
but that, where even one entire lung is hepatized,
the distress of breathing is not increased, and it ap-
pears that the respiratory changes go on under the
disadvantageous circumstances present as well as if
no alcohol had been given.
" The conclusion from all this is, most certainly,
that alcohol does not do harm in fevers and acute in-
flammations ; that it does not produce intoxication
in the persons suffering from exhausting diseases;
and that large quantities (from twelve to thirty
ounces) may be given in cases which appear very
unlikely to recover, and sometimes the patient will
be saved. The conviction is forced upon the ob-
server that in desperate cases these large quantities
of alcohol are directly instrumental in saving life,
not by exciting or stimulating to increased action,
but by moderating actions already excessive, and at
the same time by causing the heart to contract more
vigorously, and so continue to drive the blood
through the impeded capillaries."
Correction. — In Dr. Whitney's article in No.
6, page 129, Case 1, third line, for "feeling of
chyme," read "feeling of dryness."
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167
Chloride of Calcium as a Disinfectant. —
Albert Eckstein, technical chemist at Vienna, com-
mends most highly the Chloride of Calcium as a
disinfectant for latrines and similar places. He has
employed it for two years in his house, where the
privy is used daily by at least 100 persons, and has
made comparative experiments with other disinfect-
ants, with the following results :—
1. Two pounds Sulphate of Iron in solution.
After two to three hours, all bad smell had disap-
peared, but in twelve hours all the influence of the
disinfectant was lost.
2. Sulphate of Copper in solution, the same.
3. Two pounds of the Sulphate of Iron in crys-
tals— their effects lasted two days.
4. Sulphate of Copper, the same.
5. Sulphurous Acid in solution rapidly lost its
effect, and was exceedingly irritating to the respira-
tory organs.
6. Two pounds of impure Carbolic Acid filled the
house for two days with such a disagreeable smell,
that it was impossible to tell whether original odor
was destroyed or covered up.
7. Two pounds of Sulphate of Iron in a parch-
ment sack exerted a disinfecting influence for three
full days, and when the parchment sack was drawn
up it contained only some dirty, odorless fluid.
8. Two pounds of' the best Chloride of Calcium,
in the parchment sack, disinfected the privy for at
least nine days. — Zeitschrift des Oester-Apothek-
Vereines, Feb. 10, 1873.
The Resuscitation of Newly-Born Chil-
dren.— * * "All children in whom animation is
suspended in consequence of a too protracted pas-
sage from the womb to the outer world (whether
from want of uterine exertion or insufficiency of
room in the passage) may, in my opinion, be divi-
ded into two classes. The first is composed of those
in whom the head suffers from a redundance of
blood, and the second, of those in whom the head
is deprived of its proper quantity. In the first class,
the redundancy is generally met with in cases where
the head presents naturally, but is born some time
before the remainder of the body. At first it is of
a natural color, but as the uterus continues to con-
tract around the body, forcing it into as small
a compass as possible, the blood is gradually
driven more and more into the head, which becomes
turgid, and when at last the body is expelled, we see
the head often almost black, and the body perfectly
white. In these cases, the escape of a teaspoonful
or so of blood from the funis, before it is tied, as
is generally taught and known, aids us very much
in our efforts for the child's recovery, which consists
mainly of artificial respiration, the hot bath, cold
sprinkling, and the application of other stimulants
and irritants to the skin.
" In the second class, and this it is with which we
have more particularly to do, taking as before a typ-
ical case, the anaemic condition of the head, and
consequently of the medulla oblongata, and that
portion of the spinal cord from whence the cervical
plexus is given off, is met with in footling and breech
presentations, where the head and neck are both
last, and the supply of blood through the funis is
nearly or altogether stopped.
" Supposing a considerable interval of time to have
elapsed between the birth of the body and the ex-
pulsion of the head, we frequently find some such
conditions as these : the body and the head pale,
and apparently bloodless ; not exactly the reverse of
those we meet with in the first class, because, al-
though in both cases that part of the child which is
pressed upon by the maternal parts last, is most
emptied of blood, in the second class, the absence
of blood, caused by the pressure on the umbilical
cord, prevents a too great congestion of any part of
the child. We have, then, a pale flaccid body,
scarcely any or perhaps no attempt at respiration,
and a few pulsations of the heart in the minute,
more or less irregular. We at once make use of
one or other of the various methods of artificial-
respiration, not forgetting the hot bath. Time goes
on, and beyond a greater regularity and frequency
of the pulse, and a few attempts at respiration, and
perhaps a mottled hue of the skin of the body,
the head always remaining pale and death-like, we
do not seem to have progressed very much. There
seems to be no alternative but to go on, hoping the
slight improvement will continue, and very often
perseverance and skill do at last succeed in effecting
a recovery.
"Now I cannot see how we can expect a 'co-ordi-
nate and adapted action of the muscles necessary to
respiration,' if they receive no nervous supply, nor
can the medulla oblongata receive the impression
of the necessity of breathing, and reflect it to the
phrenic and other motor nerves, unless a due supply
of blood be furnished to it. How then are we to get
the blood where we want it ? I answer, by inverting
the child, and so forcing the blood by its own weight
to the lowest part, that is, the head and neck.
" About two years ago I was endeavoring to reani-
mate a child, whose appearance and condition were
just as I have described. More than half an hour
had elapsed, and although the child showed no signs
of a relapse, it made little if any progress. I took
it carefully by the thighs, and held it upside down,
gently swinging it backward and forward. In a
few seconds I was pleased to see, that although be-
fore the whole body was pallid, now the head, and
back of the neck, which was in view, were becoming
red and turgid, and almost directly afterward, the
child gasped violently, inspired, and gave as loud a
cry as I ever heard from a new-born child. After
ten seconds or so, I reverted it, when all respiration
ceased, and the head became white. I then invert-
ed it again, when the respiration and crying re-com-
menced, and I allowed it to hang by its thighs for
at least a minute, rubbing it well over the back of
the head and neck, and pouring hot water over it.
When the action of the lungs seemed to have fairly
set in, I allowed it to lie on the nurse's lap with its
head lower than its feet, and so it remained all night.
The next day it was quite well.
" It was very interesting to notice how the reflex ac-
tion manifested itself while the child was turned up-
side down, the stimulus of cold, applied to the back
of the head, shoulders, and upper part of the back,
acting on the diaphragm through the superficial
branches of the cervical nerves and the phrenic.
This entirely ceased when the respiratory tract was
insufficiently supplied with blood, as it was when
the child was held upright. This is the history of
my first case, and I was much struck with the deci-
sive results obtained. Since then I have had alto-
gether nine cases of this class, which I may here re-
mark, though it is perhaps scarcely necessary, is by
1 68
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far the more dangerous of the two. Of these nine,
two never breathed, and the heart sounds could only
be heard two or three times. They died almost im-
mediately after birth. The other seven recovered.
They varied considerably in regard to the time which
elapsed before they could breathe naturally, but in
all of them, I was able to materially shorten my la-
bors, and the anxiety of the by-standers, by invert-
ing the child as soon as a few attempts at respiration
had been made. I think I have shown pretty plainly
that this simple procedure is of considerable use, in
addition to the other means, supplementing but
never superseding them." — John Gregory, L. R. C.
P. E., in " The Doctor," 1872.
Chinese Pharmacy. — Dr. Ferrand (La France
Medicate, March 15th, 1873) says the Chinese
materia medica is very extensive, and the majority
of the substances found in European pharmacies
are found in China. The Chinese hold that many
substances have special influence on particular ail-
ments, and that nature has offered to man signs by
which to recognize substances poisonous to him.
Some plants are good to make the beard grow,
others the nails, &c. The vegetable astringents,
Alum, Salts of Iron, Lead, Silver, and bitters are
employed by the Chinese in diarrhoea, spermator-
rhoea, atony, and sweating. They use Saffron and
Ergot of Rye, and Maize, as emmenagogues, Mer-
cury in syphilis, and Arsenic in hepatic affections
and intermittent fevers, Iron as a strengthener,
Nitre as a diuretic, . &c.
Surgical anaesthesia is not unknown to them,
whether local or general, and they make use of, to
produce it either interiorly or by rubbing on the
part, Azalea Procumbens. Chinese physicians also
know that some substances are incompatible, and
cannot be made up in the same preparation ; and
they point out certain antidotes against poisons,
such as phasulus angulatus, or arsenic poisoning.
Many other preparations are employed by them,
exactly as is done in Europe ; such as Sulphur, Ace-
tate of Copper, Castor Oil, Aloes, Rhubarb, Aconite,
Veratrum, Colchicum, Muse, Opium, and the poi-
sonous Solanaceae. Betony is used to get rid of the
effects of drunkenness, and Alisma Plantago to
make lactation more active.
Perchloride of Iron in Variola. — Dr. Sil-
berglist, in a recent epidemic of variola, obtained
very decided benefit by administering about thirty
drops of the Perchloride of Iron mixed with Glycer-
ine, every hour, until several doses had been taken.
The pustules were speedily transformed into dry
crusts, and the swelling of the mucous membrane
soon diminished. -The medicament acted both as an
astringent, through the medium of the blood, and
locally, through the Glycerine.
Silphium Laciniation. — Dr. G. A. Hali, of
Chicago, speaks highly of this remedy in the treat-
ment of mucus asthma, bronchitis, catarrh, and
other diseases involving mucus surfaces. The
symptoms are scraping, tickling and irritation of
the fauces and throat, nausea, faint feeling and
sense of soreness in epigastrium, a desire to hawk
and scrape the throat, throwing off a thin, viscid
mucus. Irritation extends up posterior nares, in-
volving mucous membrane of nasal passage, produc-
ing sneezing, followed by a discharge of limpid,
acrid mucus from the nose, attended with constric-
tion and pressure in supra orbital region. Rough
cough, attended with expectoration of yellow mu-
cus. A constriction and tightness in the lungs,
with a constant disposition to raise ; hacking, spas-
modic cough. In chronic phthisis, characterized
by copious expectoration of stringy, frothy mucus,
he has given it with great success. He gives the
remedy in the first and second decimal trituration,
two grains, gradually increasing to ten grains, every
two hours.
Dr. Bacon discredits the diagnosis of softening
of the brain. He has received into his asylum
many patients judged by their physicians to be af-
fected in this manner, but has never, on post mor-
tem examinations of the brain, found any particular
signs of softening.
Density of Water. — Thirty-nine degrees is
commonly given as the temperature at which water
attains its greatest density. Experiments conducted
by Desprets and others show that this holds good
for fresh water only. Salt water grows steadily
denser as the mercury descends, until the freezing
point is reached.
3sfews 3tem$*
Prize Essays. — The Empress of Germany,
upon the occasion of the World's Exhibition at
Vienna, offers two prizes in the sum of two thous-
and thalers each, for the following two essays : No-
1. For the best manual of technical surgery in war.
No. 2. For the best treatise on the Geneva Con-
vention. The prize essays to be sent to the Central
Committee not later than 15th May, 1874. We
wish that some of the American surgeons of our
school would enter the lists of competition for the
first prize. The extended experience which some
of them had in our recent war, together with their
great practical experience and skill in private prac-
tice, would enable them to compete with a fair
chance of success. If they failed of the prize we
might still have a work which would do credit to
American surgery.
Conium.— In the New York State Lunatic Asy-
lum, experiments have been made with Conium in
the treatment of insanity. It is found to have a
soothing effect on the motor centers, its action on
the motor tract being analogous to that of Opium
on the brain. Hence it tends to quiet and renovate
the whole muscular system. This has long been a
favorite remedy with our school in the treatment of
nervous diseases, and when given according to its
indications, in proper doses, has a powerful remed-
ial action. If our allopathic friends will carefully
study our Materia Medica in the right spirit, they
will find in it a mine of wealth. Their great diffi-
culty lies in giving the drug in too massive doses,
getting rather its drug than its curative action, and,
therefore, producing positive harm.
Arsenic in Constipation. — M. Isnard, in Le
France Med, recommends Arsenic in the treatment
of constipation, especially in females, in doses of
about the one-five-hundredth of a grain three
times a day.
Mott. — The widow of the late Valentine Mott I
died in New York, June 2d, aged 77.
A coal dealer asked a doctor " How is business?"
"Very much like yours," was the reply, "Few-ill"
(fuel).
The Medical Union.
169
iDriginal Articles.
THE TREATMENT OF DYSPEPSIA WITHOUT
MEDICINES.
By John C. Minor, M. D.
The purpose of this article is to consider the non-
medicinal treatment of the common forms of Dys-
pepsia; and more particularly, that large class of
cases which are regarded as examples of functional
disease.
It is a lamentable fact, that although researches
of the most varied and profound character have
been made into the mysteries of the digestive pro-
cess, and with the most brilliant results, those results
have been interesting rather than practical. We
know that " bread is the staff of life," that digestion
is blood-making ; but although our bread is better
than that of our fathers, our lives are worse, for we
are a generation of dyspeptics in spite of our supe-
rior cooking. A disease that has many remedies is
a hard one to cure ; and the intractable nature of
the dyspeptic stomach is upheld by the testimony of
an innumerable army of patent medicines. It ap-
pears to make little difference so far as the unhappy
dyspeptic is concerned, whether he is washed by a
hydropath, wrung out by a manipulator, or hung
out to dry on his own account, his stomach remains
most foul, and he can neither eat what he likes, nor
like what he eats. If tired of life, he seeks a relief
from earthly ills at the hands of our confreres, the
"regulars," ten chances to one he escapes with his
life and comes a worse dyspeptic than ever, to ask
what homoeopathy can do to cure him.
In looking over my own notes and comparing them
with those of others, I conclude that so far as dyspep-
sia is concerned, either our memories are bad or our
cures are few. For myself, if I exclude those whom
I "cure often," and count only those who "stay
cured," I may frankly say that 1 never cured a case
of chronic dyspepsia with a purely medicinal treat-
ment. Of the absolute cures, every one has been
due to something peculiar in the exercise or diet.
For purposes of relief, or reversing the usual idea,
as valuable adjuvants or accessories, medicines are
of great value, but they are not often curative agents
in dyspepsia.
The failure of medicines to cure the condition is,
in part, from the fact that dyspepsia is often a
habit (an unconscious one, it is true) rather than a
disease, for nerves and blood-vessels are capable of
becoming idle and dissipated when brought under
bad influences. Again, the good effect of remedies
is generally counteracted by improper or inappro-
priate exercise or diet. On the other hand, the
good effects of diet and exercise are too frequently
destroyed by remedies that accomplish either good
or evil, but have no middle course of perfect safety.
Dr. Guernsey was once, at my request, summoned
to share with me the responsibilities of a case of per-
sistent vomiting that came under my care, after
three distinguished physicians of the old school had
tried in vain to control it and the patient seemed at
the point of death. It is unnecessary to give the
details of treatment by which homoeopathy saved
the patient's life. It was somewhat suggestive, how-
ever, to notice the quantities of bottles that were left
behind by our predecessors ; and almost the last re-
mark of the old-school family physician as he pre-
sented the patient with his final mixture was: "Be
sure and shake it well, my dear madam, for other-
wise the amount of Prussic-acid in a dose might be
too great for your feeble system." So far as the
permanent cure of chronic functional dyspepsia is
concerned, the results are a thousand to one in favor
of the treatment that gives the least medicine and
pays the most attention to diet and exercise.
At once we are met with the unanimous protest
of all dyspeptics. They have lived on Graham bread
and vegetables, or they have swallowed all sorts of
slops that vegetarians inflict upon the inmates of
hygienic institutions. They have been abstemious
and frugal in every way, eating but one or two
meals a day, and all without benefit; therefore,
there is no help for them in dietetic treatment.
Perhaps not; but, as not one in a hundred with
all this hungry and thirsty experience has ever
had any proper dietetic treatment, it is worth try-
ing. As regards exercise, the dyspeptic may be al-
ready a perfect giant in strength, an accomplished
athlete, taking long walks daily, and occupied, per-
haps, in some business that gives him constant exer-
cise, and yet he has not had the kind of exercise suited
to his stomach, and has to learn from a new experi-
ence that a healthy digestion is not the necessary
accompaniment of huge muscles or a portly habit.
His habits of life may be regular in all respects, and
still they may be in direct violation of the laws of
health. In fact, there is a wide-spread misappre-
hension about the whole subject of diet, exercise
and other kindred topics, that arises from the fact
that the popular authorities have given certain rules
which are blindly followed, in utter disregard of the
continual evidence that Nature's work is never du-
plicated, and that Avhat may be a law of health to
one will perhaps lead another into positive disease.
It follows naturally, that each case must be care-
fully isolated and studied by itself, and that the
remedial measures must be adapted to the patient's
peculiarities of temperament, constitution, habit, or
whatever you choose to call those characteristics
that distinguish his individuality.
If we can discover the cause of the dyspepsia, if
we can trace it to any indiscretion in eating or drink-
ing, or to any other palpable source, the cure is, of
course, an easy one in most cases. But, unfortu-
nately, the problem is generally a difficult one, and
in a large majority of cases, even of those that we
cure, it remains unsolved. In the absence, then, of
any discoverable cause for the trouble, or, in other
words, in most cases of dyspepsia, our treatment,
whether medicinal or dietetic, in most cases resolves
itself finally into a series of experiments upon the
digestive system.
In considering the treatment of dyspepsia with-
out medicines, there are two methods that are es-
pecially worthy of trial. The first relates more to
exercise than to diet, and in my opinion and experi-
ence, is applicable to every form of functional dis-
ease of the stomach or abdominal viscera, and is
more reliable than any other single method. Dr.
Dio Lewis first reported the process, and I give its
description in his own words :
" Some years ago a physician in New York city
published a small book, in which he gave well-
written certificates of marvelous cures of dyspepsia.
Patients began to flock to him. Their introduction
to his treatment was very queer. He took the
170
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patient into his consultation office, examined his
case, and if it was one he could cure, he announced
his fee at one hundred dollars, to be paid in advance.
If the patient's confidence was strong enough, the
money was paid, and then the doctor took him
through a hall, up a flight of stairs, through another
hall, then through a room, down a flight, then to
the right, then to the left, and at last they arrived
in a small room without windows, artificially lighted,
and in that room the patient was required to put
his name to a solemn vow that he would never re-
veal the modes of treatment. This being all fin-
ished, the patient was introduced to the treatment.
It consisted in slapping the stomach and bowels.
Besides this, the patient was required to live temper-
ately, and much in the open air. On rising in the
morning he was required to spend from five to ten
minutes in striking his own abdomen with the flats
of his hands. Then he went out for a morning
walk after having drank a tumbler or two of cold
water. At eleven o'clock in the forenoon he spent
a quarter of an hour or more in slapping the bowels
with his hands. Then he laid down to rest. He
dined temperately at two o'clock, and spent the
afternoon in sauntering about. At seven o'clock in
the evening he repeated the percussion, and went
to bed at nine o'clock. A majority' of the cases of
dyspepsia that sought relief at this establishment
had used all the other means except the slapping ;
that is to say, they had lived on plain food and
much in the open air. It was the slapping, the
pounding with the fists, kneading with the fists,
sometimes with the fists of an attendant, that cured
these people, for cured they certainly were. Mar-
velous cures were effected at this establishment.
After the death of the doctor, some of the patients
felt themselves absolved from the obligation, and
one of them described the treatment to me. In
every case of indigestion, no matter what may be
its character, slapping the stomach or bowels with
the flats of the hands on rising in the morning,
four hours after breakfast, and in the evening on
going to bed, is excellent treatment. I cannot con-
ceive of a case of chronic indigestion which such
manipulation would not relieve. If the patient be
so weak that he cannot perform these slappings or
kneadings upon his own person, the hand of a dis-
creet assistant should be employed. It is marvelous
how the body, the stomach for example, which,
when these manipulations are first practiced, may
be so very tender that the slightest touch can hardly
be borne — it is marvelous how, in two or three
weeks, a blow almost as hard as the hand can give
is borne without suffering. If you have a pain in
the side or across the chest, percussion will relieve
it almost immediately. But constipation, dyspep-
sia, torpidity of liver and other affections of the
abdominal viscera are relieved more surely and
completely than any other class of affections by
percussion, kneading, etc. Such treatment comes
under the head of counter-irritation, a new circula-
tion is established in the parts near the point of suf-
fering and congestion. Besides this, especially in
abdominal troubles, the manipulations appeal di-
rectly to the contractility of the weak relaxed vessels
in the affected parts."
My own experience fully confirms nearly all that
is claimed for this process. In many cases I have
found it unnecessary to pursue the treatment so far
as in the description given. The efficacy of the
method is not, in my opinion, due to counter-irrita-
tion, as Dr. Lewis supposes, for in that case other
counter-irritants, such as blisters, mustard plasters,
&c, would accomplish the same result. But we
know that mere counter-irritation has no such effect,
and hence we must look a little deeper for the ex-
planation of this peculiar action of the slapping
process. To my mind, the most rational explana-
tion is found in the mechanical determination of the
blood from the centre toward the surface. It is
probable, and, reasoning from such pathological
data as are most closely connected with the subject
in hand, we might perhaps say it is certain, that in
all cases of dyspepsia, from whatever cause, there
is a more or less congested condition of the capil-
lary vessels of the digestive organs, and that what-
ever treatment will restore the proper balance of
circulation will cure the case. Now that is just
what this treatment accomplishes. A brisk rubbing
of the skin with the hand or a course towel also
determines the blood to the surface, but in this case
it is only the circulation of the skin that is stimu-
lated; the slapping brings the blood from a greater
distance, and affects the most central organs. Tak-
ing this view of it, I have depended mainly on the
slapping, and have seldom found it necessary to give
any special rules of diet or open air exercise further
than to see that the diet was wholesome and the
exercise sufficient without being fatiguing. There
is generally no need of interrupting the business of
the patient. If he slaps himself as often as he eats,
two, three, or four times a day, it is sufficient. This
operation must not be performed immediately after
eating; two hours, at least, should intervene be-
tween the meal and the exercise. I have remarked
that this treatment is adapted to every case of dys-
pepsia, but I must confess that in the dyspepsia of
pregnancy I have not tried it ; although I believe,
if judiciously used, it would do good, yet in this in-
stance my practice and my theory remain separate.
The second method is not so generally efficacious
as that of the mysterious physician quoted by Dr.
Lewis, but it is adapted to a wide range of cases,
and it bears the high authority of Dr. Brown-
Sequard. This treatment I have also tested suffi-
ciently to say from experience, that it is in many
cases an excellent method, but I have much less
confidence in it than in the one I have given. It re-
lates not to exercise but to diet, and is, practically,
a very difficult method of treatment. I present
Dr. Brown-Sequard's account of it condensed from
the original :
" In 1851," says Dr. Brown-Sequard, "I had to
treat a very bad case of dyspepsia, and succeeded
in curing the patient by a plan of treatment which,
I think, deserves attention. Since that time I have
employed it with complete or partial success in a
number of cases of dyspepsia, of chlorosis, of anae-
mia, and also as a means of ameliorating or curing
nervous affections caused by gastric disturbances or
poverty of blood. I could not say, as I have not
kept notes of all the cases, how many times it has
succeeded or failed. In a number of instances where
failure occurred, I have found that the patients had
not carefully followed the rules, and that the failure
was, at least in a good measure, due to this lack of
care. In two cases only some increase of flatulency
and of acid eructations took place during three or
four days, when the plan was given up. In a case
of dropsy, attended with anaemia, dyspeptic pains
The Medical Union.
171
were increased for a week, when the plan was
abandoned. These are the only instances I re-
member in which some bad effect was produced
by this plan, and this aggravation soon ceased.
• ' The first patient I submitted to this plan was a
scientific man, 34 years old, of strong constitution,
but reduced, from several causes, to a lamentable
state of health. For about eight years he had been
working'very hard, taking no exercise, and living
almost all the time in a vitiated atmosphere. He
slept very little, and usually passed 18 or even 19
hours a day writing, reading, or experimenting.
His diet was miserable, and, with the object of
avoiding the need of much food, he took a great
deal of coffee. He gradually, though slowly, be-
came exceedingly weak. His digestion, which had
been very good all his life, before he began to work
so much, had gradually become very bad. He
suffered greatly from pyrosis, and a feeling of great
distress, and gastric distension after each meal.
Acid eructations and gas were frequently thrown up
into his mouth, and when he did not vomit he found
that his food remained on his stomach so long, that
in the morning he frequently rejected things eaten
the previous day. At last he had to give up work
and stay in bed. But no improvement occurred
from the rest he then. had, or from various modes of
treatment. His emaciation and weakness and dys-
peptic symptoms increased, and his friends decided
to have him removed to the country. Rut he was
so weak that he had to be carried in a litter to the
railway station. After a few days, finding that he
had not improved, I decided to try a radical change
of his alimentation, as regards the quantity of food
to be taken at a time. Instead of three meals a
day, I made him take sixty or more. Every twelve
or fifteen minutes he took two or three mouthfuls of
solid food, chiefly meat and bread. He drank a
little less than a wine-glass of Bordeaux wine and
water every thirty or forty minutes. On the very
first day this mode of alimentation was begun, his
digestive troubles disappeared, and within a week
he was so well that he returned to Paris, not, how-
ever, to go to work again, as he had been rendered
wiser, but to prepare to go to the sea-shore. He con-
tinued the same mode of alimentation for about
three weeks, and then gradually diminished the
number of his homoeopathic meals, and increased
the amount taken at each of them, until in about
eight or ten days he came to eat only three times a
day, and a full meal at each time. His strength
during the first week had become almost as great
as it ever had been previous to his illness. Since
that time up to this moment his life has been one
of great hardship, which he has borne remarkably
well, and dyspepsia has only troubled him in a slight
degree, rarely and for short periods.
" In one case only besides the preceding have I
I seen as rapid a return to health. That was the case
J of a young lady whom I saw last year at Jamaica
; Plain, in consultation with my learned friend, Dr.
S. Cabot, of Boston. In the case of this lady there
; was this additional good effect to this hygienic treat-
\ ment, that the bowels, which were very costive be-
i fore, began to act pretty well almost at once.
"The plan, as stated in the above case, consists
'in giving but very little of solid or fluid food or any
kind of drink at a time, and to give these things at
regular intervals of from ten to twenty or thirty
minutes. All sorts of food may be taken in that
way, but during the short period when such a trial
is made, it is obvious that the fancies of patients are
to be laid aside, and that nourishing food, such as
roasted or broiled meat, and especially beef and
mutton, eggs, well-baked bread, and milk, with
butter and cheese, and a very moderate quantity of
vegetables and fruit, ought to constitute the dietary
of the patients we try to relieve. This plan should
be pursued two or three weeks, after which the
patient should gradually return to the ordinary
system of eating three times a day. * * *
" I will not enter into a long explanation to show
how a marked benefit or a cure can be obtained in
functional dyspepsia, in anaemia, and other affec-
tions, by this mode of alimentation ; I will simply say
that the facts I have observed agree with the view
that we are naturally organized, like most, if not all,
animals, to eat very frequently, and not, as we do,
two, three, or four times a day. It seems certain from
the facts I have observed that functional dyspepsia,
when once it has begun (never mind by what cause),
is kept up and increased by distension of the walls
of the stomach. This fact is already well known,
and physicians generally recommend that the quan-
tity of liquid taken be very small, and that the solid
food be as nourishing as possible, so that its bulk
may be reduced, with the view of avoiding great
dilatation by the fluid and solid substances intro-
duced in the gastric pouch. But although deriving
some benefit from this diminution of distension,
many patients continue to suffer who might be
benefited or cured by the plan I propose. * * *
" It is probable that the good obtained from this
plan in dyspeptic patients depends at first on the
rest given to the irritated stomach, and subsequent-
ly on a great amelioration in the quality of the
gastric juice.
" In anaemia and chlorosis, not complicated
with dyspepsia, the advantage of this plan lies in
the rapidity of formation of blood from the notably
increased amount of food that the patient can
digest.
" I have made but very few trials — and incom-
plete ones — of this plan in cases of organic affections
of the stomach. I cannot but think, however, that
it deserves being tried in most of such cases.
"Against the obstinate vomiting of pregnancy
this plan has already been employed successfully by
a number of physicians, and once by myself in a
case in which many modes of medical treatment
had failed."
My experience with this treatment has been more
satisfactory in cases of organic disease of the stom-
ach than with purely functional dyspepsia, and
naturally so, because the dyspeptics were well
enough to rebel against the treatment — the others
were not, until the treatment had made them so.
In one case of stricture of the pyloric orifice, and in
another of cancer of the stomach, the effect of this
treatment was very marked, although both patients
eventually died. In the dyspepsia of pregnancy it
has been of the greatest service to me.
The practical consideration of the question of food
is a topic that is most satisfactorily disposed of by
those who know the least about it. "If educated
men in general," says an English writer, "were to
be instructed in physiology, and knew the amount
of untiring energy, strong will, and zealous hope,
which have been expended by minds of large cali-
bre, in the endeavor to push scientific research to a
172
The Medical Union.
union with practical dietetics ; if they saw the inca-
pacity for unraveling what we know must be the
simplest knot, the daily overthrow of hitherto cer-
tain facts in the process of digestion, and the inabil-
ity to put others in their stead, there would be no
danger of their being ' puffed up ' by such knowl-
edge." After reading the " Chemical Letters " of
Baron Liebig we are convinced that the process of
digestion is merely a process of combustion, and
that the human frame is an animated combination
of a gas stove and a steam engine, requiring only
certain proportions of coal and water or their equiv-
alents for its proper working. But in Moleschott's
" Handbuch der Diatetik," which Dr. Lehmann
says is the best that has been written on the subject,
we find Baron Liebig's theories scattered to the
winds. But Dr. Lehmann again gives us hope when
we read in his " Physiolog. Chemic :" "As the found-
er, after he has assayed the ore, knows how to mix
his fluxes in a proportion corresponding to its con-
tents and suitable to smelting it, so should it be the
aim of the physiologist to calculate for a given
organism under given circumstances the proportions
in which the individual alimentary principles must
be combined so as to ensure a favorable result."
How do these theories, the result of scientific re-
search and experiment, work in actual practice? In
one case a careful application of dietetics failed to
affect in the slightest degree a case of dyspepsia of
long standing. The patient grew worse and suffered
intolerable anguish of mind and body. The food
passed away undigested, or was rejected from the
stomach. I resorted to the use of pepsin, bismuth,
and the usual list of remedies used by the old school,
of which I was then a member, and finally aban-
doned all special treatment and contented myself
with giving the blandest and most nourishing diet
in small quantities, frequently repeated. Still the
patient grew worse, and finally was attacked with
dysentery, which was at that time prevailing as an
epidemic. After the patient was apparently be-
yond all hope, dying as I supposed, I was dismissed
from the case, and an old quack, who had never
read a book in his life and was unable to write his
name, but had what he called " a natteral gift," was
called in. He cured the patient, not only of the
dysentery but of the dyspepsia as well, and his
treatment, moreover, was a purely dietetic one.
Observing that "Any one could see that the innards
of the man was sore and wanted greasin'," he pro-
ceeded to grease them accordingly. Taking a
quantity of mutton suet he melted it and fed it to
the patient, a tea-spoonful every twenty minutes.
He was kept on this diet exclusively for ten days,
and then gradually resumed his ordinary food.
This experience has not convinced me of the neces-
sity of " greasing the innards" of dyspeptics, but it
is merely one of many examples that have led me,
when considering the subject of food, to accept the
conclusions of scientific authorities with but moder-
ate enthusiasm, and never to discard an empirical
treatment because its modus operandi is not under-
stood. Another case in point occurs to me. A
gentleman of this city, whom I have known for
twenty years as a thin, emaciated, dyspeptic-looking
individual, has lately attracted my attention from
the wonderful and rapid improvement in his appear-
ance. He is now in perfect health, of robust habit,
his flesh firm and solid, and displaying in every
aspect the evidences of a vigorous mind and body.
In search of practical information, I inquired if he
knew the cause of his rapid improvement: "Of
course I do," he replied, " two goblets full of water £
every night, just before going to bed, for six months,
raised my weight from one hundred and fifteen
pounds to one hundred and fifty." His theory of
his case was a peculiar but not an irrational one.
He was not a dyspeptic, but partly from his seden-
tary life and partly from unknown causes, his health
was never good. He felt as though he was being
consumed by an inward fever. With very little
body- work and almost incessant head-work, his vital
machinery had been thrown out of balance, so that
there was too much friction somewhere. He drank
but little at his meals, and, upon thinking over his
case, he concluded that the blood in his emaciated
body, instead of being too thin, as he had always
been told, was in reality too rich — his system needed
more water. He resolved to test the matter by liv-
ing in all other respects as usual, but at night, just
before retiring, he would drink two goblets full of
water, not ice water, and this habit he would con-
tinue without variation for six months. At first it
was hard work to take down so much water at once,
but in a short time he became accustomed to it, and
the improvement began so quickly that his treat-
ment was well supported by the palpable evidence
of success.
And so, if time permitted, I might go on giving
cases, no two alike but all pointing to the same
practical inference, viz.: That "one man's meat
may be another man's poison." The rules of die-
tetics as laid' down in the best works, as supported
by the ablest experimenters among the physiolo-
gists, and as accepted by a large proportion of the
profession, are, in actual practice, a source of much
disappointment to physician and patient. And this
arises, I believe, from the fact that those rules are
intended to cover the general average of healthy
stomachs, and so far perhaps they are reliable. But
in practice, every case is an exceptional one in some
respects, and nothing but disappointment can be
expected to result from an attempt to supply the
necessities of a deranged system by administering
the food required for a healthy one.
Are we, then, to throw aside all the results of scien-
tific inquiry on the subject of food and trust to pure
empiricism? By no means; but we will succeed
best when, as Bacon expresses it, "being learned,
we incline to the methods of experience ; or being-
empirics, we incline to the methods of learning."
The researches of physiologists have shown that
there are certain essentials in the process of diges-
tion which cannot be omitted without the probable
occurrence of dyspepsia-— they are absolutely requi-
site for thorough digestion. Therefore, the physician
will attend carefully to these particulars in dyspep-
tic cases, even though other treatment, such as the
slapping process, or Dr. Brown-Sequard's method
may be necessary to perfect the cure.
There must be, in the first place, a thorough masti-
cation and insalivation of the food. Hence, it may be
necessary to prescribe a good set of artificial teeth as a
scientific remedy for some dyspeptics ; and in this
connection, it will be well to remember that, as was
shown by the late Dr. Walter Williamson, of Phil-
adelphia, dyspepsia may be produced and perpetu-
ated by wearing artificial teeth on "rubber plates,"
the trouble having been traced directly to the mer-
curial symptoms produced by the coloring matter
The Medical Union.
173
in the plates. One patient of mine, who resided a
short distance from the -city, was cured of dyspepsia
by being advised to take a later train in the morn-
ing, thus enabling him to devote half an hour to his
breakfast, instead of five minutes, as formerly. In
some cases proper insalivation will not take place if
the food is insipid or unsavory. The salivary glands
may need stimulation by more palatable food, and
possibly, by the use of spices, high seasoning and a
variety of condiments, such as are generally con-
demned by the popular authorities as productive of
dyspepsia. Such treatment, it is admitted, is not
often required, but there are some cases in which it
is positively necessary.
In the second place, the food must be thoroughly
mixed with gastric juice in the stomach ; and this
implies a proper muscular action of that organ and
a sufficient quantity and quality of the gastric fluid.
We know that over-distension of the bladder will
paralyze that organ so that it cannot expel its con-
tents, and we may assume with confidence, that an
over-distension of the stomach may in like manner
result in a paralysis of its muscular coat. There-
fore, when we find a dyspepsia occurring from over-
feeding, we must direct our attention to the prob-
able existence of a paralytic condition more or less
complete. In these cases we may use Dr. Brown-
Sequard's method of* a great many small doses of
food instead of three meals a day, as the most
rational and a very effectual treatment. It operates
upon the stomach just as the use of the catheter
does upon the paralyzed bladder, by preventing dis-
tension, and thus permitting the muscles to recover
their tonicity.
The muscular contractions of the stomach are
under the control of the sympathetic system of
nerves ; hence, any strong emotion, exciting news,
or intense mental strain will take away the strong-
est appetite. Such causes, at times, appear to
stop the entire digestive process ; the secretion
of the fluids ceases, and all muscular action is in-
terrupted until the cause is removed. At such
times, the food might as well be out of the body as
in it ; and this brings us to another practical point.
The good old-fashioned habit of eating a hearty din-
ner in the middle of the day, and a light tea at six
o'clock, is often held up as a model for dyspeptics
to follow. But we must remember that most of our
patients, in this city at least, are business men,
actively engaged all day long in the most intense
application to their pursuits, and that if a hearty
dinner is taken at noon, the chances are that but
little of it will be digested until after business hours.
Therefore, we may often give the best advice to our
patient by recommending a light meal at noon and
a six o'clock dinner.
If we suspect the trouble to lie in a deficient
secretion of the gastric juice, we may accomplish
something by supplying the deficiency with pepsin.
Electricity may also be used, not only to increase
the secretion, which it does most effectually, but
also to stimulate the muscular action of the stomach.
It is not, however, as efficient in its action upon the
muscular coating of the stomach as would be sup-
posed, its principal use, with me, in dyspepsia, has
to stimulate the glandular secretions. A mild cur-
rent from the galvanic battery has been of the most
service.
Lastly, the food must be acted upon by the biliary
and pancreatic fluids, and the peristaltic action of
the intestines must exert its proper influence. The
length of time that elapses after taking food, before
the dyspeptic symptoms begin, careful percussion of
the stomach, the seat of pain, and the general char-
acter of the symptoms, will often enable us to deter-
mine whether the source of the trouble is in the
stomach or below it. If the difficulty begins just as
the food passes into the duodenum, we may suspect
that' the liver or pancreas is at fault. The con-
comitant symptoms, the existence of piles, the color
of the skin and sclerotic, the appearance of the ex-
creta, &c, will enable us to decide as to the liver.
A pancreatic lesion cannot be recognized, however,
except, in rare cases, by the character of the feces.
The regurgitation of food mixed with bile, the ex-
istence of habitual constipation, &c, will give us
some idea of the location of the trouble. As to
treatment, the slapping process will prove of general
use. Electricity will also be of assistance, and in
many cases curative. The administration of the
" pancreatic emulsion," an English preparation,
made, as I suppose, from the entire organ, pre-
served, without cooking, in palatable shape, is of
great service in some cases.
In many of these cases a medicinal treatment will
materially assist the cure, but it is surprising how
much can be done without medicines, and it is worth
while to see what can be accomplished by other
methods first, before resorting to their use. Want
of space obliges me to omit a consideration of the
effects of particular diets, change of climate, &c.
Pregnancy with Imperforate Hymen. —
Several cases have been recorded, at various times,
in which impregnation has taken place, although
the hymen presented only a small opening. Dr.
Karl Braun adds a remarkable instance. A married
woman, aged twenty, was sent to him from Galicia
to have the Csesarean section performed, as she was
pregnant, and the vulva was completely closed. On
examination, there was found to be a membrane
extending from the rectum to the urethral orifice,
and presenting not the slightest trace of an opening.
On introducing a catheter when the bladder was
full, the result was sometimes the evacuation of a
large quantity of urine, while on other occasions
only some white acid mucus, apparently vaginal,
escaped. It was also found that a fine sound
could be introduced into the opening and felt
through the rectum, while at the. same time the
bladder was emptied by the catheter. It became
evident that the vagina opened with the urethral
canal into a common outlet. Dr. Braun divided
the membrane from the urethra to the rectum. The
patient was in due course delivered of a healthy
child, and returned home a month afterward. Dr.
Braun also adds an account of another case lately
under his care in which the opening in the hymen
was only two lines wide. — British Medical Journal,
1872.
Results of Pregnancy in Primiparal of
Advanced Age.— Drs. Cohnslein and Ahlfeld have
given the histories of 500 primiparae, whose ages
varied from thirty to fifty years. They show that
pregnancy in these women was attended with more
numerous accidents than in young primiparas.
Operative interference is much oftener necessary and
more dangerous, and the mortality in children is
also greater. — Gaz-Hebdrom, February, 1873.
i?4
The Medical Unioii.
CLINICAL NOTES FROM PRACTICE.
By Egbert Guernsey, M. D.
Articular Rheumatism. — There is no disease, per-
haps with the exception of gonorrhoea, so trying to
both physician and patient as rheumatism. When
you think you have fairly mastered it you find it has
only gone off to some other joint, or that it has at-
tacked the heart, the very citadel of life, and is there
sending its thrills of pain through every nerve in the
body. The deformities which often follow this dis-
ease, the stiffened joints, the valvular disease of the
heart, the organic change within the cavity of the
head, the ravages wherever the serous membrane
is found, cause us to watch its movements with pe-
culiar care. A venerable old clergyman, esteemed
alike for his piety and his rare intellectual acquire-
ments, once said to me as I entered his room and
found him writhing in agony, with the drops of per-
spiration standing all over his face, "this is the
d st disease I ever saw." A moment after, when
the paroxysm of suffering had subsided, he attempt-
ed to apologize for his language, but I interrupted
him by assuring him that the occasion quite justi-
fied him, as I did not believe any other word in
the English language would fully express his feel-
ings.
In rheumatism there is undoubtedly an increase
of lithic acid in the blood dependent on excess of
the secondary digestion ; and notwithstanding there
is considerable excretion of acid by the skin, there is
an undue balance between the excess of lithic acid
and the power of excretion ; hence, in our treatment
we have to work not only at the local inflammation,
but also at the nutritive functions, so as to insure a
due balance between the amount of matter entering
the blood, as the results of digestion, and that dis-
charged by the excretory organs. Study the symp-
toms as carefully as we may, we often find our-
selves baffled in our treatment, and remedies failing
to act as we hoped and expected. Perhaps if we
had our patients entirely under our control, and
could regulate not only their medicine, but their
diet and the temperature of the room, we should be
more successful. Dr. Fuller very justly says, "that
what is wanted, is far less the discovery of untried
methods of treating disease, than, of discriminating
canons for the proper use of those we possess ; far
less the discovery of any new medicine, than the
adaptation of our present remedies to the exigencies
of each case." And yet the arcana of nature is so
full of remedial agents, that when we find ourselves
so often baffled in the old paths, instead of studying
with more care old remedies, we are apt to take a
fresh start and look out for something new.
The following cases are narrated to show the ef-
fects of a remedy which I had never used in its
present form, until within the last year, and the ex-
ceedingly happy results obtained from it.
A lady of middle age, and of full habit, consulted
me in reference to a severe attack of articular rheu-
matism. The attack was preceded by considerable
fever, with gastric derangement. The marked febrile
symptoms soon subsided under the influence of a
few doses of Aconite, but the knee became very
much swollen, red, painful to the touch, with severe
throbbing pain, and the slightest movement attend-
ed with severe agony. My experience with the pa-
tient in this disease (she had suffered from several
attacks before) was not a pleasant one, it running
a course very much to suit itself, paying but little
attention to any remedies I could suggest, and
sometimes lasting several weeks. I prepared thirty
drops of Propylamin in four ounces of water, and
gave her a dessert-spoon every two hours. In half
an hour after the first dose, she said with a smile
of gratification, "You have hit it this time, I can
feel it go directly to the spot." There was a steady
improvement ; in twenty-four hours the pain had
entirely ceased, and in forty-eight hours every ves-
tige of the inflammation, at first so violent and so
painful, had disappeared.
A few days after this case had terminated so fa-
vorably, I was called to see a gentleman who had
suffered repeatedly from severe rheumatism. The
attack usually commenced in the ankle, or wrist,
and he was fortunate if in a short time the knee and
elbow were not involved. The inflammation was
violent, and the pain correspondingly severe. As I
entered the room, he said to me, "Well, doctor, I
am in for a month's siege, I suppose. " "I hope not, "
I said. " Of course, you hope not," was the reply,
"but my organization must be peculiarly obstinate,
for the cursed thing generally runs its course in
spite of medicine. I thought I would send for you
just to try a new hand, but I have not the slightest
idea you will be any more successful than the
others." I ordered sixty drops of Propylamin in four
ounces of water, and a dessert-spoon to be taken
every two hours. The result exceeded my expecta-
tion, for I found on my visit the next morning, he
had passed a tolerably comfortable night, the pain
having very much subsided and the swelling sensi-
bly diminished. At my next morning's visit, I found
both the pain and swelling had entirely subsided and
the disease was fairly mastered.
Elated with the brilliant results thus obtained, I
resolved to try it in a case where there was but lit-
tle, if any, inflammatory action, but more a stiff-
ness and aching of the muscles and joints. The
result was an entire failure, the medicine produ-
cing no perceptible change in the character of the
disease.
I have since tested the drug pretty thoroughly in
various forms of rheumatic troubles. It has only
been successful in the purely congestive or inflam-
matory type, and in these cases its action has been
really brilliant. Its use thus far is, I believe, simply
empirical, as I am not aware that any proving has
been made. Dr. Franklin, in his excellent work on
surgery, speaks of it in high terms of commenda-
tion,, and M. Dujardin Baumet, in quite an exten-
sive and thorough trial of the drug, says, "The
pain at first was diminished, then the movements
became easier, and the swelling in the joints rapidly
disappeared. The duration of the attack was much
shortened." Dr. Awenarius, of St. Petersburg,
first called attention to the use of this drug in rheu-
matism, for which he considered it so much of a
specific that he thought doubtful rheumatism could
be diagnosed by its successful use in a few days.
Between March, 1854, and June, 1856, he treated,
in the Hospital Kalinkin, 250 cases with success. It
has also been successfully used in severe cases of
prosopalgia, and in paraplegia and hemiplegia, re-
sulting from rheumatism. The Propylamin of com-
merce is usually obtained from herring pickle, in
which it was first discovered. It is a colorless liquid
The Medical Union.
175
of a characteristic odor, having decidedly the pun-
gency of ammonia, which is generally mixed with it.
It is soluble in water and alcohol, has a strong alka-
line reaction, and forms crystallizable salts with the
acids. It consists of carbon, hydrogen and nitro-
gen, and its formula is C6, H9, N. It is obtained
also from cod-liver oil, by reaction with ammonia in
distillation. No other officinal fatty oil yields a
similar product. Dr. Winckler has obtained from
ergot, by distilling the watery extract with potash, a
volatile alkaloid which he named secalin. This
alkaloid has been ascertained to be identical with
propylamine the odorous principle of herring pickle.
The peculiar odor of ergot is probably owing to the
liberation of its volatile alkaloid. It is very proba-
ble that the virtues of ergot are, in some degree,
connected with this alkaloid. It has also been
obtained as an artificial product from narcotin,
codein, and has been found in saline combination in
the flowers of cratagus oxycantha, sorbus aucuparia,
and one or more species of chenipodium.
Hemorrhoids and Prolapsus of the Rectum. — Our
readers will remember two very interesting articles
published in the early numbers of this journal on con-
centrated petroleum, or vasoline. A quantity was left
with Mr. Hurlburtfor general distribution among the
profession, with a request that they would report
the result of their experiments and investigations.
From the large amount distributed, it is hoped we
shall yet obtain some rich clinical experience.
A gentleman about sixty-five years of age called
on me a month since suffering from severe hemor-
rhoids. I found the parts swollen, painful, and very
much inflamed. He informed me that he had suf-
fered for years from prolapsus of the rectum, hav-
ing to replace the parts after every stool, and often
after any unusual physical exertion. I recom-
mended the free application of vasoline. The relief
was immediate, and in three or four days the trouble
had entirely disappeared. I recommended the con-
tinued use of it after every movement, hoping to
strengthen the parts and overcome the troublesome
prolapsus. It was applied with a brush to the ordi-
nary water closet paper, and used after every stool.
In two weeks time the prolapsus ceased, the parts
becoming strong, and the sphincter having very
much increased its contractive power.
Accidental Poisoning by Camphor. — Last summer
I was called in great haste to see a lady, suffering,
as I was informed, from a severe attack of cholera.
During the cholera epidemic of 1849, and the less
severe but more recent epidemics, I have had scores
of cases under my care (as well as sporadic cholera
almost every summer), in every stage of the disease,
from the first invasion to the last stage of collapse.
On entering the room I was startled at the terrible
picture of cholera which was presented — the worst
stage of collapse. Here was the shriveled and
pinched face, the sunken eyes, the hoarse voice,
the cold, clammy sweat, the burning thirst, the
fearful cramps, the retching and vomiting, the
scarcely perceptible pulse, and the rice water evacu-
ations pouring from the bowels, as if all the fluids
in the body were escaping. The case brought
vividly to mind the scenes I had so often witnessed
in the fearful cholera summer of 1849. On making
careful inquiry I found for a pain in her stomach
she had taken over a tea-spoon — the precise amount
I could not determine — of a saturated solution of
camphor. This was the result — a poisoning by cam-
phor producing all the symptoms of cholera so ac-
curately that even my experienced eye in this disease
might easily have been deceived.
MEDICAL UNION CLINIC.
GELSEMINUM IN CEREBRO-SPINAL AFFECTIONS.
By J. N. Tilden, M. D.
While there are, in the practice of every physician,
unsatisfactory results from the administration of
medicines occurring almost every day, still we can
often get such conclusive evidences of the potency
and usefulness of proper medication as to serve for
encouraging landmarks for our future benefit. The
following case furnishes one of those satisfying guide-
posts which give hope and help along the routine of
professional life and labor :
Sadie H , aged two years and four months,
always well until four or five months since. Has all
her teeth save four. Her indisposition has con-
sisted in her having (as the mother describes them)
" spells," seems to be dizzy, has a frightened look,
says she is afraid ; if standing or walking, will fall ;
apparently cannot see, and cannot move; the mus-
cles refuse to obey volition ; is irritable and peevish.
These "spells" last for only a short time, not to
exceed fifteen to twenty seconds, and then she
seems to be all right again. Her appetite is good,
but there is difficulty in discharging anything from
the bowels, although the feces are soft. Sleeps well.
These attacks at first were infrequent, occurring once
in three or four days. She was placed under allopathic
treatment, and after a course of treatment, extending
over a period of nearly three months, comprising the
administration of Bromides, Syr. Rhei, Hyd. Cum
Creta, Potassii Iodidi, &c, &c, we find her now
having the paroxysms often three or four times daily.
The parents relate the history of the case, say-
ing: " She is getting so turned against the medi-
cines that she cannot keep them on her stomach,
and we called you to see if you cannot give her
something easier to take."
Prescribed Tinct. Gelseminum, three drops in
half a glass of water ; take two tea-spoonfuls every
three hours while awake. Third day of treatment,
had one paroxysm (which formed the first evidence
of improvement), and from that day, February 17th,
1873, to the present date, August 4th, 1873, there have
been no indications of a return of the trouble, her
health having been apparently perfect in every respect.
This sudden and complete recovery was not due to
the eruption of the remaining teeth, for they did not
make their appearance until several weeks after her re-
covery. The medicine was continued at longer inter-
vals for a couple of weeks after the last paroxysm.
In conclusion, I would state that while the above
case offers an admirable group of symptoms upon
which to display the curative properties of Gelsem-
inum, it is a medicine which has given me great
satisfaction in a large class of nervous diseases,
such as intercestal neuralgia, headaches, &c. In
eight cases of sporadic cerebro-spinal meningitis
(some of which I hope to report at a future time),
it has been my main reliance, and thus far, no case
under the treatment has proved fatal in my experi-
ence. I would be glad to hear from some of the
readers of the Union as to their experience from
using Gelseminum in cerebro-spinal diseases.
PeeksMU, N. Y., August 4, 1873.
iy6
The Medical Union.
SECONDARY PLEURISY OF A PURULENT
CHARACTER FOLLOWING SMALL-POX -
INUTILITY OF MEDICINES- RAPID RE-
COVERY UNDER SURGICAL TREATMENT.
By Dr. Cramoisy.
Translated by Dr. John C. Minor.
[Bulletin de la Societe Medicale Homoeopathique de France,
July ist, 1873. )
A pathological problem of the utmost im-
portance presents itself to the attentive physician
for solution with each new case of pleurisy. But if
he studies well the nature of these numerous diffi-
culties., he can without hesitation determine the
line of conduct he ought to pursue. Not unfre-
quently the treatment is of itself all the more
dangerous to the patient as the necessity for its use
becomes more urgent, and its expediency can only
be justified by an analytical study of the totality of
the symptdms which characterize the disease.
Having been convinced of this idea, and approv-
ing the general and complete method brought out
by our honorable colleague, Dr. Parthenay, in one
of his latest cliniques with reference to the treat-
ment of secondary pleurisy, I believe that the follow-
ing experience, selected from my private practice,
will have a peculiar value in the eyes of my confreres.
It is then of the greatest importance to know that
a pleurisy which is developed in the course of a
scarlet-fever, puerperal fever, small-pox, or other
contagious disease, will become a fatal secondary
pleurisy, giving rise to an exudation rich in pus,
and for which, in consequence, all medical treat-
ment is useless, and it will become necessary to
have recourse to surgery. Such is my own opinion,
and that of my learned friends Drs. Dieulafoy and
Hay em, with whom I have made a great number of
autopsies, which have always confirmed this con-
clusion.
It is to be well understood that I do not class
simple serous pleurisies, constituting an uncompli-
cated disease, in the same category; nor those
pleurisies, wrongly called secondary by some
pathologists, which complicate acute articular
rheumatism, nor those which from long standing
have become purulent; nor those again with pul-
monary complications such as gangrene of the lung,
hydropneumathorax, or pulmonary tuberculosis.
The variety of pleurisy which I wish to describe
to my colleagues, and which necessitates at once
the operation of thoracentecis, is one that should be
classed among the disorders of nutrition, due to
suppuration of the plural sac from some external
cause, such as the contagion of scarlet-fever, small-
pox, &c. It is not such a secondary pleurisy as
attacks a debilitated patient already suffering from
another affection ; such complications depend upon
a strongly marked predisposition on the part of the
individual to inflammatory diseases in general, and
to pleurisy in particular. The pleurisy of which we
speak is developed with such rapidity, that all its
pathognomonic signs are shown at the very be-
ginning, — dullness, the souffle, asgophony, dim-
inution of the thoracic vibrations, swelling of the
thorax of the affected side, &c, and, as the German
authors very justly remark, it terminates generally
in death. Dr. Jousset holds the same views with
reference to pericarditis of a like nature.
The purulent effusion is not absorbed of itself, nor
is it aided by medicines. It does not resemble
those pleurisies whiclj I will mention as inappro-
priate for tapping, and in which the fluid is ab-
sorbed with tolerable facility with or without treat-
ment. I have said enough concerning this form of
pleurisy to show that all medical treatment may be
abandoned, since its use is never crowned with suc-
cess ; while, on the other hand, as I am about to
prove, tapping the pleura once or several times,
with or without a washing out of the cavity, is the
only treatment which permits the suppression of the
purulent matter developed spontaneously in a closed
cavity of vital importance, by virtue of a determinate
predisposition, as has been shown in so masterly a
manner by my venerable and lamented teacher
Tessier.
Victor Laplace, five years old, blonde, of nervous
temperament, and of marked lymphatic constitution,
since he had at the time a scrofulous ulceration on
his upper lip, was attacked, during January, 1873,
by small-pox of moderate intensity, which confined
him but a few days to his room.
On the 15th of January, about eight hours after
the appearance of the variolous vesicles, the child
was suddenly taken, all at once, by a high fever,
headache, oppression in breathing, incessant and
spasmodic cough, nocturnal insomnia, constipation,
and almost complete suppression of the urine.
The parents called, in succession, two physicians
of the neighborhood, who did not recognize the
pleurisy — one treating the child for teething, and
the other for bronchitis. On the nights of the 5th
and 6th of February, 1873, the little patient had
two terrible attacks which frightened the parents.
They were characterized by the following symptoms :
At midnight, while half asleep, after a coughing
fit, the child suddenly sprang up in his bed with
piercing shrieks — he was afraid of all around, his
eyes were wild, his countenance purple or bluish,
and he foamed at the mputh. These symptoms are
the paroxysms of pain, which those pass through
who die asphyxiated, and our little patient was just
on the point of expiring from syncope caused by an
obstruction of the right side of the heart by the
pressure and augmentation of the fluid contained
in the left pleura.
Finally, convinced of the critical state of their
child, the parents determined to call me to the case
upon the next day, the 9th of February, and behold
in what a condition I found the little patient, as
demonstrated by physical examination.
His heart was pushed way over to the right side,
entirely beyond the median line, and, by a patho-
logical anomaly, there was neither souffle, bronco-
phony, nor aegophony, but a perfect immobility of
the diseased side of the thorax, exaggerated thoracic
vibrations on the sound side, perfect dullness, with
enormous distension of the thorax on the affected
side ; in a word, the left thoracic cavity of the little
fellow was filled to the utmost extent with a fluid
which, from the circumstances already mentioned,
I knew to be purulent. The pulse was 120, the res-
piration 40 and the temperature 37.4 (cent.)
As I had but little hope of a cure from remedies,
I forewarned the family that an operation would be
necessary, unless within a few days I should obtain
a diminution of the effusion. I prescribed Cantharis
1 , five drops in half a glass of distilled water, a tea-
spoonful every hour and a-half, and a very rigid diet.
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177
February loth. The same condition. All the
stethescopic symptoms remain as before. The child
passes more urine. I alternated Cantharides with
Arsenicum.
February nth. The child has slept all night and
part of the day ; is not so restless. The urine is
more abundant, and presents a deposit on cooling.
Upon auscultation the same phenomena are pres-
ent, but the breathing is not so labored and is
smoother. Upon percussion, I find a diminution of
one or two centimetres in the effusion. Continued
the same remedies.
February i2tk. The fever and chills continue.
The appetite does not return, and the effusion re-
mains the same. Continued the same remedies.
February 13th. The child is much worse, he has
not slept, and during the night another attack oc-
curred, less severe than the two preceding. Per-
cussion, made with the greatest care by means of
Trousseau's instrument, shows that the liquid has
again completely filled the chest ; all the symptoms
already noted from the commencement remain as
before. My confidence in remedial measures is
gone. I hesitate as to the proper course to pursue,
for there is on the one hand a child's life to save,
and, on the other, our therapeutics must not be
compromised. In the meantime, until the danger
is more imminent, I decide to try the remedies indi-
cated by Dr. Gallavardin in his clinical lectures,
published in the 27th vol. of DArt Medicate. I
give Senega I every hour.
February \\th. The child has slept, without
waking exhausted; he has had a slight perspiration
and three turbid emissions of urine. The left side
is completely full. I continue the same remedy in
a higher dilution and alternate it, every two hours,
with Hepar sulphur 3d.
February i$th. The same condition. Continue
Hepar sulphur 1st, in alternation with Bryojiia.
February 16th. The child continues in the same
state, but is growing weaker and more oppressed
for breath. In accordance with my expectations,
not a single remedy had been of any use for ten
days past, and I did not dare to try them longer.
I told the family that the operation alone could save
their child. The father and mother placed the
matter entirely in my hands to do whatever in my
judgment was best for the patient. As I did not
have my aspirator with me, I deferred the operation
\till the following day, and, having passed in review
all the remedies indicated by Dr. Gallavardin in the
other varieties of purulent pleurisies, as Silicea and
Sulphur were all that remained for me to give, I
alternated the two.
February ijth. No change in the condition. The
heart is always on the right side, and it interests me
greatly. The dyspnoea is very great, and there is
no respiration in the left half of the chest. As the
danger is no greater to-day than yesterday, I wait
another day in order to give the last two remedies
a chance to show their worth or their inutility.
February 1 8th. The child being in the same state,
I finally performed thoracentecis, with Dieulafoy's
aspirator, which I had put off so long solely in the
interest of our school, and drew off 600 grammes of
opaque fluid, greenish in color, which, on examina-
tion with the microscope, proved to be full of pus
globules. As soon as the fluid had been drawn off,
I auscultated and percussed the heart and left lung.
The first had returned very nearly to "its place, and
the second was resonant throughout its whole ex-
tent, and gave the vesicular murmur, mixed with a
few moist rales, and a slight friction sound from the
pleura.
I stopped all remedies, and gave nourishing diet.
February 19th. The thoracic vibrations have re-
turned, and for the first time I can hear a light
souffle and aegophony at the base of the lung, due
to the return of a little of the fluid, and also a few
sub-crepitant rales, mingled with the vesicular mur-
mur. The child has slept all night long without
coughing, and there is no more oppression. Has
passed his urine four or five times within twenty-
four hours.
February list. Very great general improvement.
The child is in good spirits, with good appetite and
a better complexion. For two days he has had no
cough. The urine is still turbid, the pulse 90, and
the temperature 38.3 (cent.)
The febrile state has entirely disappeared with
the effusion, and the puncture with aspiration has
not given rise to any new issue of fluid.
February 28th. The child as completely cured of
his pleurisy, and of his scrofulous eruption [treated
with Iodine 6], and I have ceased visiting him.
As a corollary of what I have already stated in
my preliminary observations, I would say that, in
my opinion, this variety of pleurisy is a purulent
diathesis, just as simple and natural as an abscess in
the parenchyma. For those who do not admit the
existence of the purulent diathesis, an abscess of the
parenchyma is readily explained on the principle of
a phlebitis, an embolism, or a thrombus ; neverthe-
less, these explanations are untenable when applied
to suppurations of inter-articular, or of serous
cavities as in my case.
We cannot perceive the migration of pus globules
in nature, nor the extension of proximate disorders,
so long as the vessels are intact. Hence there arises
the necessity that pus should develop anywhere
spontaneously. Tessier, in sustaining this simple
and natural theory of pus formation, has not been
under the necessity of interposing any special agent.
He and all those who wish to observe without pre-
judice, have seen abscesses form spontaneously in
all the organs and tissues, under the sole influence
of a simple predisposition, which he has called a
determinate predisposition, in precisely the same
way as an ordinary phlegmon or small-pox pustule
forms without any reason for suspecting any primit-
ive vascular obliteration, or the occurrence of a
blood clot. As regards the nature of pus, upon
which physicians have speculated so much, it is
hardly necessary to waste much time. It is a
question that cannot be solved, and depends mainly
upon the idiosyncracies of the individual, which we
can no more explain than we can the various colors
of the hair. Our medical authorities show nothing
when they say that pus globules are merely the
white globules of the blood, serving as a vehicle for
infection, and to which they have given a variety of
names of similar meaning: Thus, some call them
poison, others virus, miasma, fermentation, and,
Anally, sepsin. All these theories have, in appear-
ance, something tangible, and yet are nothing but
hypotheses whose nature permits of eternal dis-
cussions, without scientific progress and without
benefit to the sick. Of what importance is it to us
that in the malignant forms of the purulent diathesis,
the blood and the purulent exudation are filled with
178
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quick-moving bacteriae, while in the non-malignant
forms spheroid microcosms are found whose move-
ments are slower and limited? These infusoria
have not caused the disease, they have only made
their appearance because an element propitious to
their development has occurred, just as the growth
of favus only appears upon a scrofulous skin.
Finally, from all this I conclude that my little
patient had a purulent diathesis, developed by a
pleurisy, and partaking of the nature of the metas-
tasis of small-pox.
A SELF-PRODUCED ABORTION AND ITS CON-
SEQUENCES.
By J. Titus Deyo, M. D.
In the recital of the following case I do not pro-
pose to enter at all into a discussion of the morality
of the question involved, but shall simply confine
myself to a history of the case, its train of some-
what remarkable complications, my treatment, and
the result.
In the early part of April last, I was waited upon
by a female apparently about 26 years of age, and,
to all appearances, an accomplished and respectable
lady. The object of her visit was for the treatment
of what she suspected to be venereal disease. A
physical examination showed her fears to be ground-
less, there being nothing manifested to justify any
such suspicions, merely some slight mucous abrasions
of the lower part of the vaginal canal and labia, re-
sulting, as I supposed, from a leucorrhcea of an acrid
character. The assurance I gave her to that effect
seemed to afford her the most gratifying relief. I
prescribed for her condition, and she left without
having given me the least intimation as to whom
she was or whither she came.
Some two weeks subsequent to this time, I was
surprised at her making me a second visit. She in-
formed me that the trouble, for which I prescribed
at her first visit, was entirely removed: She stated
that she had been married, was divorced from her
husband some two years since, and, unknown to her
family and connections (most of whom are well
known and prominent residents of one of our largest
New England cities), she had been living with her
former husband during the past winter, and, as a
result of such indiscreet action, believed herself now
to be pregnant, and advanced in the same about
two months ; that it was imperatively necessary she
should be relieved of her present difficulty, in order
to save her reputation, and most beseechingly
solicited my good offices to assist her in this sore
strait. After having satisfied myself of the fact that
pregnancy really did exist, I mildly, yet emphati-
cally, refused to accede to her request either directly
or indirectly. She then stated that she had entirely
exhausted the category of domestic remedies and
nostrums, and was fully determined on ridding her-
self of this incubus, as she termed it, and to accom-
plish her purpose, would resort to an instrumental
operation at her own hands, being confident of her
ability to perform it.
I knew, from her tone, that this was no idle
threat. I endeavored to dissuade her from taking
any such measures, informing her of the exceeding
great personal risk she would subject herself to by
so doing, but all to no purpose. She left, and I
heard nothing further from her till Thursday P. m.
following (this being Tuesday), when I was sent for.
I strongly suspected the cause of her illness, and at
first hesitated about having anything to do with the
case, but finally decided to visit her. I called at
about 8 o'clock P. M., found her confined to the
bed, and in the following condition : laboring under
great mental and febrile excitement ; dilated pupils ;
weak pulse; almost spasmodic rigidity of the limbs;
an exceedingly melancholic expression of the face ;
continual nausea and vomiting ; suffering the most
intense gastric, abdominal, and uterine cramps,
accompanied by strong bearing-down pains occur-
ring every few minutes, and followed by considerable
arterial hemorrhage from the vagina. On inquiry,
I ascertained from her that, on the previous day,
she had attempted the accomplishment of her
threat, employing for the purpose a flat piece of
ordinary whalebone, in length, I should judge, from
10 to 12 inches, one end somewhat curved, and
sharpened almost to a point. This self-prepared,
infernal instrument she had endeavored to introduce
into the uterus, repeating the attempt a number of
times ; after which, she had injected into the vagina,
several times, at . intervals of two or three hours, al-
most scalding hot Holland gin, so strong and hot as
to almost wholly denude the vaginal canal of its
lining membrane. To make "assurance doubly
sure," she had been taking, during that whole day,
table-spoonful doses of Fluid Ext. Secale Cor. every
hour.
The severe vomiting which the drug occasioned
each time when swallowed, was undoubtedly the
means of saving her life, for such quantities of the
poison had she taken, that had even one-third been
retained in the stomach, it would have been suffi-
cient to cause death, or at least such a condition as
would have ultimately resulted fatally; as it was,
sufficient of the drug had gone into the circulation
to produce the physical effects aforesaid.
I immediately made a digital examination,
which caused most excruciating pain, and found the
vulva greatly tumefied, prolapsus of the uterus, the
cervix much swollen, though in a flabby, pendant
condition ; the os somewhat dilated, and each uter-
ine pain followed by a gush of pure, red, arterial
blood. The condition of the parts as ascertained by
this examination led me to suspect that the instru-
ment had been introduced in so bungling a manner,
by reason of the operator's ignorance of the anatomy
of the parts, as to penetrate the vaginal walls, punc-
ture the os and cervix in several places, and,
undoubtedly, to have entered the cavity of the
uterus, and perhaps, passed through its contents
and entered the parenchymotous uterine structure.
This condition of. affairs I subsequently ascertained
to be the case.
I felt that that it would be folly for me to attempt
to arrest the threatened abortion, that being now a
foregone conclusion.
I prescribed Bell, and Arnica, alternated every
half hour, until about 4 A. M., when most of the
symptoms had abated. At 8 o'clock the uterine
spasms entirely ceased, but returned at 10 o'clock
with tenfold intensity, as did likewise the hemorr-
hage. In less than a half-hour, as a result of one
of the most severe pains, the entire contents of the
uterus were expelled; the foetus was from 2 to 2^
months old. The sac, which was partly filled with
coagula, showed two ugly and ragged-looking open-
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179
ings, one opposite the other, which proved conclu-
sively that the instrument used had passed entirely
through it and entered the uterine wall at the fun-
dus. The hemorrhage following the expulsion was
most profuse, so much so, as to cause me consider-
able alarm. I gave Caulophyl., and Cinnamom,
and made manipulations over the uterine region,
with very little effect. The contractile power of
the organ seemed entirely gone. I then gave Opii
et Camphor, pil. [U. S. P.] and the flow somewhat
lessened during the next hour, still it had been to
such an extent as to throw the patient into a condi-
tion approaching syncope. I now decided to give a
solution of Quiniae Sulph., grain doses, repeated
every half-hour. In less than two and one-half
hours from the time of administering the first dose
the hemorrhage wholly ceased, the patient felt
stronger, and she slept for several hours.
The following day vaginal injections were ordered,
of equal parts of Calendula, Hamamelis and tepid
water, the canal being in a perfectly raw condition.
This afforded almost immediate relief, its applica-
tion being required for two days only. A bad dys-
enteric diarrhoea now set in, but was speedily
checked by Arsenic., and Merc. Cor.
Everything now passed along nicely, but I was
constantly on the look-out for metritis or peritonitis,
not being thrown off my guard by this apparent
immunity, knowing full well that there was only
wanted some adventitious circumstance to establish
this inflammatory condition, and this circumstance
soon came. In spite of my having given her ex-
plicit instructions as to her remaining quietly in bed
for several days, she very foolishly on the following
Wednesday morning, whilst in a state of profuse
perspiration, seated herself in front of the open
window during the time the nurse was arranging
her bed. The result of this indiscretion may be
easily imagined. She was attacked with an extra-
ordinarily severe chill, lasting fifteen to twenty min-
utes, followed by vomiting, this in turn being suc-
ceeded by lancinating pains in the left ovarian
region; skin hot and dry; burning fever. I was
sent for in haste, but did not get the message in
time to see her before 9X P. M. In the meantime
the attendant had sent out for some Dovers Powders,
several of which had been taken by the patient, the
stomach being in such a weakened condition, how-
ever, that none were retained, each succeeding pow-
der only causing more severe vomiting and materi-
ally aggravating her condition. I found her in a
raging fever ; muttering delirium ; eyes staring
wildly afld vacantly ; pulse rapid and wiry ; tossing
and throwing herself about in the bed ; writhing in
agony and crying out with pain; unable to give
any intelligible answers to my various questions.
Aconite and Bell, were at once prescribed, and I
ordered hot flannel compresses of Witch-hazel and
Spts. Camphor to be applied over the abdomen, and
to be repeated every ten or fifteen minutes. I looked
upon her condition as being decidedly critical, and
dared not trust her case to an attendant, but remained
at the bed side all night, and personally looked after
the treatment. Towards morning there was a ma-
terial change in her condition for the better ; prior to
my leaving, the patient had become conscious and
begged me to give her something to produce sleep,
but I advised her against it, unless her case absolutely
demanded it. At 12 o'clock another chill, even more
severe than the first, set in, and acute metritis and
peritonitis, with their concomitant symptoms, were
developed. I continued Bell., substituting Cim.
Rac. for Aconite. She described the pains as like
myriads of knives cutting in every direction through
the entire abdomen ; incessantly continued the hot
fomentations. Night came, and being obliged to
administer Morphine, I prescribed the Acetate, one-
sixth grain doses every hour ; five doses taken with-
out producing sleep and only slightly lulling the
pain. The following afternoon her condition was
greatly improved ; fever abated, pulse less frequent,
pains not so acute, skin moist and more nearly ap-
proaching a normal temperature. I would here
state, that when the last-mentioned inflammatory
condition set in, the uterine hemorrhage likewise
appeared, which was as quickly arrested by Quinine
as previously. (In this connection I cannot speak
too highly of this remedy, looking upon it as pos-
sessing full as specific an action on the uterus as
does Sec. Cor., without producing such evil effects
as does the latter.) There was a very rapid im-
provement during the succeeding four days ; each
night, however, I was obliged to give Morphine.
Knowing that I was not yet "out of the woods,"
the treatment was still continued, fearing a recur-
rence of the inflammation. The patient had become
exceedingly debilitated; no inclination for food;
bowels greatly constipated by the Morphine [this
was removed by Leptandrin] . At this stage, when
I was congratulating myself and my patient on her
very fortunate recovery, a fresh trouble arose,
though not as dangerous, yet full as difficult to con-
tend with as its exciting cause, viz. : acute neuralgia,
which manifested itself suddenly and without any
premonitory symptoms ; the whole pelvis seemingly
involved ; sciatic and crucial nerves of the left side
being also affected. The pain was of the most
excruciating character and almost unbearable,
infinitely worse than those caused by the preceding
inflammation; aggravated by the slightest motion,
yet she could not lie in any position to command
ease or any degree of freedom from pain. I pre-
scribed Rhus Tox., and Colocynth, and the use of
the Ungt. Veratrice as a counter-irritant. The
neuralgia was protracted and obstinate ; in a meas-
ure, the result of the severe prostration. Palliatives
were necessary to give temporary relief, and the
whole trouble only disappearing with returning
strength.
Persons who prefer to run the risk of perform-
ing surgical operations upon themselves rather than
incur the expense of employing a doctor, should
take warning from the fate of a young man, named
Herron, who recently died near Hamburg, Iowa,
from the effects of a bungling attempt to vaccinate
himself. He had procured some virus from the arm
of his sister, who had been vaccinated by a regular
physician several days previously, and placed it in
his own arm, in an ugly gash made for its reception.
To prevent the matter from getting out, he took a
piece of damp newspaper, and bound it upon the
wound. In a few days afterward, the arm began to
get stiff and exceedingly painful ; but the symptoms
were not those of cow-pox. A doctor, having been
finally sent for, made an examination of the wound,
and found that mortification had set in. Amputa-
tion of the limb was subsequently performed. The
shock, however, proved too great for the strength
of the young man, and death occurred shortly
afterward. — N. Y. Times.
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The Medical Union.
CONCERNING THE CIMEX LECTULARIUS.
A CORRESPONDENT writes to me asking for infor-
mation concerning the Cimex Lectularius, or com-
mon bed-bug, to which I have referred in a former
letter as possessing singular powers as a remedial
agent if used in a sufficiently attenuated form.
In looking over the literature of the subject I am
surprised to find how barren it is, and how appa-
rently unfamiliar most authors are with the history,
habits and manifestations of this insect. But I am
convinced that this is a subject of which many speak
with seeming ignorance, while possessing in reality
a vast amount of practical information. The pro-
fession is a great sufferer from this modesty on the
part of its members, for it is certain that if they
would tell all they know concerning the Cimex Lec-
tularius, our literature would be enriched by most
exhaustive provings of this remedy, and its virtues
would become "Familiar in our mouths as house-
hold words. " It is necessary that some one should
perform this manifest duty both to the bed-bug and
to the profession ; and hence, I am impelled to lay
before your readers a true and authentic history of
the Cimex, with the hope that my humble effort
may stimulate some others in the profession to give
us a careful proving of the remedy, with such sug-
gestions as a large experience may furnish.
The bed-bug is, without doubt, the most ancient
of bugs. Its Latin name, Cimex Lectularius, affords
convincing evidence that it was known to the an-
cient Romans, and hence we are not surprised that
Pliny, Horace, and other classical writers should re-
fer to the Cimex in terms of familiarity. Moreover,
it is now accepted as a fact by those most learned
in antiquarian researches, that when Nero set fire
to Rome, it was the result of a most curious acci-
dent. It happened that the Emperor, having pass-
ed a most wretched night upon his bed, or lectulus,
awoke, and perceiving a Cimex upon his pillow, ex-
claimed, " Acus sed bugis mell/" Springing from
his bed, he siezed a kerosene lamp that stood upon
the mantlepiece, and, in attempting to burn the
bug, he set fire to the mosquito netting, and thus
the conflagration began. In view of these facts,
how superficial must have been the investigations of
those English writers who claim that the bed-bug
was brought over to London from America shortly
after the destruction of that city by fire, in 1666.
But so it has ever been with the Cimex : its claims
neglected, its antiquity doubted, its beauties un-
sung. Burns has embalmed a louse in verse, and
the flea is celebrated in the literature of all nations.
The story of St. Dominic and the flea is most in-
structing to those whose minds are of a religious
turn. The king of fleas keeps his court at Tiberius
as Dr. Clarke and his fellow- traveler discovered.
It was of a flea that Mephistopheles sung in the
Leipsic cellar. The flea of Poictiers was the occa-
sion of more poems than scratches. But the bed-
bug has no literature, and therefore my researches
in quest of the habits and origin of this neglected
creature, have led me to the discovery of some his-
torical facts that are not generally known. I will
not occupy valuable time in demonstrating the error
of those who believe that the trilobites are petrifac-
tions of antidiluvian bed-bugs, nor the untenable
theory of those who hold that the Cimex is descend-
ed from a species of turtle. I only regret that I am
unable to give the name of the author from whom I
first learned the origin of the bed-bug, but my re-
membrance of the historical facts is sufficiently accu-
rate to enable me to give what may be called "The
Bed-Bug Legend."
When the ark was floating upon the waters of the
great flood, above the top of Mount Shinshan, in
Persia, a most violent storm arose that threatened
to destroy the vessel. The winds and waves raged
with terrific violence. The animals broke loose and
became wild with terror. To add a new horror to
the fearful scene, just at that moment a mighty
wave hurled the ark against the sharp top of the
submerged mountain, and stove a large hole in the
bottom of the vessel, through which the raging wa-
ters poured. Destruction appeared inevitable. Noah
rushed to and fro in the greatest consternation ; but
when he saw the fearful rent in the bottom of the
ark, instead of calling upon the Lord to deliver him,
he began to curse and to swear. Then the devil ap-
peared before him and promised to save the ark and
all on board on condition that a yearly sacrifice of
human blood should be offered to him forever.
Overcome with terror at the near prospect of death,
Noah agreed to the proposition and closed the com-
pact with an oath. The devil instantly threw him-
self into the sea, and, being transformed into an
immense serpent, he drove himself up into the hole
in the bottom of the ark and thus plugged up the
opening with his body, so that no more water could
enter the vessel. Then the tempest, which was
evidently the handiwork of the evil one, subsided, and
order was restored, for it was evident that the devil
had saved them all. But at what a price ! Noah was
overwhelmed with remorse when he considered the
consequences of his rash promise, and in his despair
he called upon the angel Gabriel, who appeared be-
fore him with his two-handed sword and bade him be
of good cheer. Then the angel told Noah to take the
sword and smite off the head of the serpent, and
when he landed on Mount Ararat, after first, offer-
ing up sacrifices to the Lord, he was to place the
serpent's head upon the altar and burn it to ashes
and scatter the ashes to the four winds of heaven.
So Noah took the sword and smote off the head of
the serpent, and when he landed on Mount Ararat,
having first sacrificed to the Lord, he burned the
serpent's head upon the altar and scattered the
ashes to the four winds of heaven. And lo! the
ashes were transformed into bed-bugs and fleas and
all sorts of blood-sucking insects, which have been
making a sacrifice of human blood ever since, in
payment of Noah's debt to the devil.
John Crannell.
Urethral Hemorrhoids. — Dr. Richat de-
cribes under this name an affection which he be-
lieves to be of quite frequent occurrence. It depends
essentially on the presence of hemorrhoidal vegeta-
tions at the opening of the urethra, accompanied with
intense pain, produced by the passage of the urine
over the sensitive and occasionally ulcerated growths.
This, as a secondary consequence, occasions spas-
modic contraction of the urethra, which is one of the
characteristics of old-standing cases. Mere excision
of the growths, the author believes, will not remove
the contraction and hypertrophy of the urethra,
which often gives rise to the most painful symptoms ;
and, in order to effect this, he advises forcible dila-
tation of the urethra, which rarely fails to give relief.
— Amer. Journal of Medical Sciences ; April, 1873.
The Medical Union.
181
The Medical Union
A MONTHLY JOURNAL
Of Medicine, Surgery, and the Collateral Sciences.
Editors :
EGBERT GUERNSEY, M.D. CHARLES E. BLUMENTHAL, M.D.LL.D.
JOHN C. MINOR, M.D. ALBERT E. SUMNER, M,D.
H. M. PAINE, M.D.
Published on the First of each Month, by
C. T. HURLBURT, 898 Broadway, New York.
NEW YORK, AUGUST, 1873.
" A regular medical education furnishes the only presumptive
evidence of professional abilities and acquirements, and ought to be
the only acknowledged right of an individual to the exercise and
honors of hisprofession." Code of Medical Ethics, Amer. Med.
Ass., Art. iv, Sec. i. .
THE STATE BOARD OF EXAMINERS IN
MEDICINE.
The history of the efforts that have been made in
this State for a higher grade of medical education is
given at length in this number of the Union, and
we ask our readers to read it attentively, and, for
the sake of the great interests involved, to give the
subject a thoughtful consideration.
It is a lasting honor to Homoeopathy that its
followers have ever been the most persistent advo-
cates of thorough scholarship in medicine. They
have approached the task with the most catholic
spirit, embracing all schools, and insisting upon a
more critical examination in all departments. The
end and aim of the law passed in 1872, and now in
operation, is to make medicine in fact what it is
already in name — a learned profession. To raise
the professional standard higher, so that to be a
doctor in medicine will be proof positive of intel-
lectual culture and ability ; to establish a degree
that cannot be bought, and that entitles the holder
to the respect of all who value sound scholarship ;
to offer an incentive to those who are conscious of
their ability to excel, and to give practical assistance
to those who will afford the best instruction to
students, — such are some of the main objects of the
law.
The operation of the law has been delayed until
the presnt time, and it is now proposed to take ad-
vantage of its provisions. It rests with the profession
to make the law a dead letter, without life and
practically void, or they can so rally to its support
as to convert it into an instrument of wonderful
force and efficiency. There is much more in it than
at first appears, and a careful attention to its gene-
ral operation is necessary in order to appreciate the
wide range of its action. It is not necessary, at pre-
sent, to consider all the features of the law, but
some of them deserve more than a passing notice,
and we would call the special attention of our readers
to its relations to colleges and schools of medicine.
Under the new law, which applies to all students
of whatever school, it is no longer necessary for the
student to attend any particular college for a certain
specified time in order to obtain the highest legal
degree in medicine. He may attend lectures at
two or three colleges at the same time if he chooses,
or may receive all his instruction from private
sources ; the degree conferred by the State Examiners
depends upon the candidate's ability to pass the re-
quired examination, without reference to the method
by which his education was obtained. Hence it
follows that, as regards the student, if he desires
this degree, he will obtain his instruction from those
who are most competent to teach, and, as regards
the colleges and teachers, those will obtain the most
pupils who give the most thorough instruction.
It is acknowledged by the profession generally,
that medical lectures are of questionable benefit to
students. No matter how distinguished and able
the professor may be, his lectures are simply a
digest of standard authorities, and all that is con-
tained in his course might be learned, perhaps
even more thoroughly, from text-books. This view
is already admitted by a majority of the best teachers
in medicine, so far as it relates to the theoretical
part of medical instruction. As regards the practi-
cal part, the testimony is even more unanimous.
Clinical instruction is admitted to be the most effi-
cient method of teaching medicine, surgery, and
general therapeutics. The dissecting room is the
only proper place to teach anatomy, operative sur-
gery, pathology, and the larger part of physiology.
The laboratory offers the only appropriate method
for thorough instruction in analytical chemistry.
These practical courses of instruction might be sup-
plemented with advantage by lectures on some of
the topics, but, if we would obtain the best educa-
tional result, the didactic teaching must be cur-
tailed, and the clinical and laboratory work ex-
panded. Text-books should in a great measure
supply the place of lectures, and the talent that now
occupies the lecture room should find a more
effective field at the bedside, in the dissecting room,
and the laboratory.
None are quicker to perceive these facts than the
students themselves, and, invariably, we find the
largest attendance where the best clinics are held.
If, to-day, a practical school of anatomy, operative
182
The Medical Union.
surgery, and physiology were to be opened in New
York, we believe there would be a larger attendance
upon its courses than upon similar but less efficient
ones in all the medical colleges combined.
With the abundance of clinical material con-
stantly offering in our dispensaries, every advant-
age can be had for practical courses of instruction
in medicine, surgery, and general therapeutics.
In every department the means for thorough in-
struction are already at hand. It is not a question
of means or resources, but of the disposition and
ability to use them.
If our medical colleges are willing to lay aside
the present inefficient method of instruction, with
which they have already expressed themselves dis-
satisfied, and adopt one that is in accordance with
the more modern and broader views of medical
science, a great step will be taken toward the
advancement of the profession and the progress of
science.
In Europe it is said of American medical men,
that they have among them excellent physicians
and skillful surgeons, but no scholars. It is pre-
cisely so. All the real progress in medical science
is made abroad, and no American makes a new
discovery in anatomy physiology, pathology, or
chemistry. From Germany, in particular, we re-
ceive most of our newest ideas and the results of
the most careful investigations ; and scientific repu-
tation in this country is oftener based on a good
memory and a knowledge of German than upon
any original researches.
Our undeniable inferiority in scientific attain-
ments is not the result of any mental inferiority.
There is a tangible cause for it, however, and
fortunately it is within our power to remove it.
We must support the teachers and give to every
one an opportunity to demonstrate the value of his
instruction.
At present, medical teaching is a monopoly,
enjoyed by those who constitute the faculties of
medical colleges. There are no private schools or
teachers of medicine, and the student must take his
choice from the existing institutions. We make no
objection to the colleges on that ground. If
monopolies, in medicine or in commerce, fully meet
the requirements of the people, we incline toward
them. But in medicine, the requirements of the
case have not been met. The student pays a high
price for a poor article, and when he receives his
diploma as a public testimonial that he is a learned
man, properly qualified to practice physic and sur-
gery, he knows that he is nothing of the kind, and
that his education in medicine is, even in his own
estimation, most sadly deficient.
Competition in teaching offers the true solution to
this educational problem. It is the very soul of
thorough instruction, and by its means we can
determine what is worthy of support and what is to
be condemned as an imposition. Whether the in-
struction is carried on under the auspices of a
college, or independently by private physicians, is
immaterial. The best teacher will have the most
pupils, and it will pay to teach well. Instead of
every professor in the college receiving the fees be-
longing to his chair, and knowing that every stu-
dent must take out his tickets, the professor who is
incompetent will receive no fees, because the stu-
dents will go to other teachers. In colleges where
the faculty serve without pay, the incompetent
professor will lose nothing but reputation and stu-
dents. In the private teaching of classes in anat-
omy, physiology, operative surgery, and pathology,
and in private courses on other special topics, the
largest opportunities for reputation and remunera-
tion will arise. The teacher whose pupils are
uniformly the best educated, as proved by the re-
sult of their examination by the State Board of
Medical Examiners, will be sure to receive the
largest support from students and practitioners.
There is no other test of teaching ability. It is
absurd that medical faculties should be the judges of
their own merits as teachers by conducting the
examination and pronouncing upon the qualifica-
tions of their own students. And here we have the
explanation of the superiority of foreign teachers
and of the progress of medical science abroad. In
Germany there are many physicians whose instruc-
tion is so thorough that students continually crowd
their private lecture-rooms, and thus the teacher is
enabled, from the fees received, to support himself
handsomely without other occupation. He is con-
stantly on the alert to seize new facts, to test new
theories, to demonstrate in the most vivid manner
the branch he teaches. It is of vital importance
with him that he should earn the reputation of a
thorough and successful teacher, for otherwise his
students will leave him to follow the instruction of
some more energetic or more competent rival. In
this manner a class of permanent teachers is cre-
ated, who devote their lives to the acquirement
and imparting of medical knowledge. They be-
come expert and absolutely proficient in the branch
to which they devote themselves, and are constantly
investigating the subjects which they teach. These
are the men who make discoveries in medical
science, who gain a lasting reputation for them-
selves and bring credit upon the name of their
country.
It is to support such men, whether connected
with colleges or not, and to give them an opportun-
ity of demonstrating their ability to teach, that the
new law aims. If such teachers are already con-
nected with colleges, then let the colleges send their
The Medical Union.
183
students before the State Board of Medical Examin-
ers, so that the regents of the University may
testify to the scholarship of the students and the
ability of the teachers. Such a testimonial would
be of inestimable value to any college, and such a
course would at once impress the profession with
confidence in the college whose students should re-
ceive the degree from the State Board.
In this way the new law may be made to contrib-
ute to the efficiency of the colleges, and enable
them to demonstrate, beyond all question, their
claims to the confidence and respect of the profes-
sion ; and it is to be hoped, if the faculties are
really in earnest when they profess a desire for a
higher standard of medical education, that they
will co-operate with the State Board in that direc-
tion.
As to the allopathic colleges, we believe that they
have the ability to conform to the provisions of the
law. There are many faithful and competent
teachers among them, but they lack the broad,
catholic spirit, and will give no support to any
measure that has so wide a scope as this. The low
standard of medical education in this country is the
result of their system of teaching, and dependent
on the strong "conservative" spirit that has been
unwilling to make any change in methods of in-
struction that were inefficient a hundred years ago.
For the existence of this law we are indebted to
Homoeopathy, and we therefore look to our Homoeo-
pathic College to take the initiative and boldly pro-
nounce its intention of preparing its students to
pass the State Board of Medical Examiners, and
win the honorable degree offered by the regents.
We feel confident that the profession at large
will give the measure a popular support, and that
they will expect a hearty response from the college.
There is a strong determination on the part of the
State Board to push this question forward, not in
any hostile spirit toward the educational institu-
tions already in existence, but with the sincerest de-
sire to unite the whole professional influence upon
the advancement of thorough teaching, the attain-
ment of accurate scholarship in medicine, and the
more rapid progress of medical science.
i£orre$pcm6ence»
CORRECTION.
In tlie last number of the Union one of the art-
icles, entitled, "A Case of Habitual Constipation,"
was inadvertently permitted to appear without
proper acknowledgment. The article in question
was by Dr. H. Goullon, Jr., and was translated and
condensed from the May number of the Neue
Zeitschrift fur Homceopathische Klinik, one of the
best of our foreign exchanges, by Dr. C. E. Blumen-
thal.
A LETTER FROM BERLIN.
Berlin, June 25th, 1873.
An invitation was given me to-day to attend the
meeting, this evening, of the Medical Society. The
proceedings commenced quite promptly at half-past
seven, Prof. Von Langenbeck in the chair. The
minutes of the last meeting having been read
and amended, Prof. Von Langenbeck related a
case which had come to him within a few day?.
The patient, a young man of twenty-two years
of age, had some months before been attacked
at night by a party of men. In the scuffle which
ensued he was struck on the head and fell
senseless, and had no memory of several severe
knife wounds, which, when he presented himself to
Prof. Von Langenbeck, had all healed but one. This
one was below the inner canthus of the right eye,
and somewhat nearer the nose. A spot located be-
low the lachrymal sac continued to discharge pus.
When it was injected, and this was done very thor-
oughly in hopes of healing the fistula, the fluid
would either escape by the nose or run down into
the posterior nares. The supposition was, that there
was necrosed bone, and Prof. Von Langenbeck op-
erated with a view to remove it. He soon came upon
a piece of metal, which was only removed by the
exertion of a great deal of force, and proved to be
about two inches of the half-inch-wide blade of a
common pocket-knife. The point of interest was,
that such a piece of foreign material could lie so
long lodged in the ethnoid bone, in such close
proximity to the brain, and yet cause no symptoms
to point to its presence there. The only pain, and
that not severe, which could be attributed to it was
in the eye.
Prof. Schweigger was called upon and made
some remarks about the use of Ether, and his rea-
sons for preferring it to Chloroform. He stated,
incidentally, that he had noticed whenever dila-
tation of the pupil occurred during the administration
of Chloroform, alarming symptoms soon followed.
He maintained that Ether, while being less danger-
ous, was not open to any objections which might
not be urged against Chloroform. The anaesthesia
was equally perfect and as rapidly induced, and
passed more rapidly off, and vomiting occasionally
follows the use of either anaesthetic. Prof. Bardele-
ben confuted these assertions, and, while admitting
that his colleague's observations might be entirely
correct in the cases in which he was accustomed to
use an anaesthetic, i. e., in operations in ophthalmic
surgery, he still asserted that in his own observa-
tions, in cases where the anaesthesia must be longer
maintained, the results were different. Prof. Lie-
breich made a few remarks about the anaesthetic
agents, and said those which chemically resem-
ble Chloroform are all more dangerous than those
which resemble Ether. All act on the brain, but
the former class go farther and produce paralysis.
Deaths from Chloroform result from paralysis of
the heart, and, although artificial respiration, if kept
up, may even be so far successful that a natural in-
spiration may be made, nothing, not even the irri-
tation of the vagus nerves with electricity, will in-
duce movement of the heart. There were some
other speakers whom I did not recognize, and some
1 84
The Medical Union,
other facts were brought forward. One case was
related where respiration having ceased during the
administration of Chloroform, not only was the
tongue found to have fallen back, but the epiglottis
was curved over backward so as to shut the entrance
to the glottis completely. This obstacle removed,
respiration was immediately recommenced. Prof.
Virchow now made some rather extended remarks
in regard to a so-called "Wild-man" brought from
Russia and now on exhibition here. The man is a
posthumous child, and, therefore, Dr. Virchow
thought there might be a shadow thrown on the cer-
tainty of his paternity, no brother or sister or other
known relative showing the same peculiarities. The
most striking thing is that the entire face, head and
neck are covered with hair. It is said that he was
so abused by the other inhabitants of the village
where he was born, that he lived for a long time alone
in a cave or hole in the ground. He married and had
two children — a boy and a girl. The former died
and is said to have resembled the father. The man
himself and the girl were exhibited to the assembled
doctors. The girl had not such a monstrous growth
of hair as the man. Long, fine, downy hair, how-
ever, grew out in two large locks from the ears and
also from the lower and outer margins of the orbits
as well as from the supraorbital region, and from
some other parts of her face. Similar hair grew
from out his nose and meati auditorii externi, whilst
his entire face was covered with hair which was thin
enough to allow the skin to be seen through, only on
the end of his nose. Dr. Virchow alluded briefly
to the imperfect accounts of hairy folk on the Jap-
anese island of Yeddo, and said that one other case
such as that under consideration had been fully re-
ported as occurring in Siam, where a father, daugh-
ter, and grandson, had such development of hair as
these two persons, and, as in these cases, ac-
companied with a remarkable absence of the usual
number of teeth. Of the five persons in these two
families one had all four incisors of both jaws and
one tooth more on the lower jaw — in all, nine
teeth ; none of the others had as many. The man
presented to us had two incisors above and four be-
low —in all, six teeth. The child had four incisors
below, but no teeth at all in the upper jaw, the
alveolar process not being developed. The unusual
development of hair on human beings, so far as ac-
curately observed and described, may be divided
into three classes: I. The bearded women, of which
several have been seen. In these it is not strictly
unnatural. The growth occurs with them only in
the same regions where it is commonly seen in the
other sex. II. Nae.vi pilosi, in which there is at the
same time an abnormal development of the skin
itself in the same regions. IIL Such cases as those
before us. Now, inasmuch as we have occurring in
regions far separated from one another, two well-
authenticated cases of these combined peculiarities,
to wit: superabundance of hair on the face and
want of the usual number of teeth, occurring, too,
hereditarily, we are led to these thoughts : I. That,
accepting Darwin's theory of selection, if these
people were to find wives and husbands like them-
selves, and were to prove more rugged and
better able to endure the wear and tear of life
than the ordinary man, a new race, possessing
these peculiarities, would spring up. II. That,
accepting Darwinism again, these cases are cases
of Atavism and evidences that similar peculiari-
ties existed in a common ancestor many generations
back, and possibly that the origin of the human race
is to be sought rather among the Edentata, where,
together with an abnormally small number of teeth,
we find a superabundance of long hair on the fore
part of the body, than among the highest devel-
oped forms of animal life such as the Quadrumana.
A motion to adjourn was carried and the meeting
broke up. The meeting was conducted throughout,
much as such meetings are with us. The great dif-
ference being in the presence of so many men whose
opinions are accepted as authority not only at home,
but wherever medicine and surgery are based on
scientific principles.
Charles A. Bacon, M. D.
Cransacticms of Societies.
[We give below a concise history of the movement for a
higher medical education, condensed from the Report of the
Bureau of Medical Education, made to the N. Y. State
Homoeopathic Medical Society. The Report will be of
great value to those who wish to fully understand a subject
which has been much discussed in the past, and which will
be actively agitated in the future. — Eds.]
ELEVATION OF THE STANDARD OF MEDICAL
EDUCATION-STATE BOARD OF
MEDICAL EXAMINERS.
By H. M. Paine, M. D.
The elevation of the standard of medical educa-
tion has been attempted many times during the
past twenty or thirty years. Its importance has
been stated repeatedly at gatherings of medical
men ; various plans have been proposed for securing
a higher standard of preliminary qualifications and
a more thorough knowledge of all the departments
of medical science. While the present status is a
decided improvement on the requirements enforced
thirty or forty years ago, it is clearly inadequate to
meet the wants of the present day. Admission to
the ranks of the profession, with the full enjoyment
of all its privileges and immunities, is obtained far
too easily and quickly.
Since the presentation of this report, thirteen
years ago, scarcely any progress has been made by
the allopathic school in securing a higher standard
of medical education. Attempts have been repeat-
edly made to induce the nearly fifty allopathic
medical colleges in this country to adopt a uniform
standard of requirements. Failure has attended
every effort. Partial success has attended the
attempt to obtain a graded course of study, but not
until the plan had been adopted by one or more
homoeopathic medical colleges.
And, now, after a trial of more than sixty years,
the allopathic school acknowledges that the standard
of medical education can scarcely be lower, yet
offers no new plans nor recommends any radical
change.
No adequate or uniform standard of preliminary
requirements is enforced; students are still com-
pelled to listen to, at least, two courses of lectures,
which are essentially the same, and the teaching
and licensing interests are still united.
To the homoeopathic profession of this State
belongs the honor of having taken a step in advance
of that attained by either their allopathic or homceo-
The Medical Union.
185
pathic brethren in this or any other country. They
have projected a system which, if faithfully carried
k out, will be far more effective than any hitherto at-
tempted.
The first decided attempt at reformation in this
direction was made by the Hon. Stephen J. Colahan,
member of the Constitutional Convention, which
held its sessions in this city in the years 1 867-68. Mr.
Colahan, after a very long and patient investigation
of the whole subject, projected and reported the
following form of a proposed amendment to the
Constitution :
" Constitutional Convention, Feb. 6, 1868.
"Report of the Committee on the Prac-
tice of Medicine and the Com-
pounding of Drugs.
" The undersigned, a special committee, appoint-
ed to consider the question of raising the standard
of the medical profession in this State, and of regu-
lating the dispensing and compounding of drugs,
respectfully present the following article for adop-
tion by the Convention :
"Section i. The Legislature, at its first session
after the adoption by the people of the amendments
proposed by this Convention, shall enact laws cre-
ating a State medical board, before which all candi-
dates for admission to practice medicine in this State
shall pass a satisfactory examination.
" § 2. In tne organization or creation of said
board, none of the schools of medicine now recog-
, nized by law, or hereafter to be recognized, shall
have a major representation.
"§ 3. The Legislature shall make it a criminal
offence for any person to practice medicine in this
State without the license or authority of the afore-
said board — excepting, however, such members of
the profession as now are possessed of authority
from some legally incorporated medical college of
this State, or such as are recognized by a legally in-
corporated medical society of the same.
"§ 4. The Legislature shall confer authority on
the respective pharmaceutical societies, legally in-
corporated, to regulate the dispensing and com-
pounding of drugs/ and shall make it a criminal of-
fence for any person to compound drugs in this
State without the authorization of such society. But
practising physicians who compound their own
medicines shall not be included in this prohibition.
"Your committee have carefully avoided what
might be deemed legislation, and have offered in
the proposed article but a frame-work which, when
perfected by the Legislature, will, in their opinion,
relieve the public to a great extent from the com-
plained-of evils. No question more vital to the
health and life of our people has been considered by
this body. The people of this State ask not to be
made altogether dependent upon the pleasure of the
Legislature. They have received in the past no re-
dress from such source. Action on this subject has
been generally demanded. Some sixteen hundred
petitioners have asked your protection, and the pub-
lic press of the State have demanded reformation at
your hands. Not a single remonstrance has been
presented to the Convention against the proposed
measures to raise the standard of the medical profes-
sion and for the protection of the public.
"We have done much to protect the property of
our citizens ; let us not avoid responsibility, but do
the more sacred act still, protect their lives. "
The State Homoeopathic Medical Society indorsed
the measure and expressed its approval at its annual
session, held in February, 1868, by the adoption of
the following resolutions:
"Resolved, That this society fully realizes the im-
portance to the people of this State of protection
against empiricism and ignorance of pretenders in
medicine ; also, the importance of the elevation of
the standard of medical education ; we, therefore,
respectfully recommend the Constitutional Conven-
tion now in session for the purpose of revising the
Constitution of this State, that the article proposed
by the committee appointed thereby be embodied
in the fundamental law of the State.
"Resolved, That the Secretary be requested to
place a copy of the foregoing resolution in the
hands of the Hon. S. J. Colahan.
At the same meeting Dr. W. S. Searle of Brook-
lyn, presented a form of a proposed law which he
had prepared, and which had been introduced in the
Senate and referred to the Committee on Medical
Matters.
Dr. Searle stated, substantially, that the object
contemplated by the bill he had prepared was the
advancement of medical science and the suppression
of empiricism. The act provides for the appoint-
ment of a State Medical Bureau, to be nominated
by the legally -recognized medical societies of this
State, respectively, and to be appointed by the
Governor. Said bureau to be so constituted as
that the representation of the different schools shall
be as nearly equal as possible. As it is not proposed
to affix any penalty to the infringement of this reg-
ulation, or to interfere in the least with the present
legal requirements regarding the practice of medi-
cine or surgery, it will constitute an honorary degree,
of which only those who are really meritorius and
fully qualified can avail themselves.
It is a notorious fact that, under the present sys-
tem, many incompetent and ignorant practitioners
are graduated from our medical schools, both allo-
pathic and homoeopathic. By means of the degree
proposed to be created, the public may be enabled
to determine, as fully as may be feasible under any
system, who are duly qualified practitioners.
It is only with great difficulty and in exceptional
cases that irregular practitioners are made to bear the
penalty attached to the present forms of legal re-
quirements. For two hundred years all laws of this
description have proved a dead letter in nearly all
cases. All that it is possible to accomplish, there-
fore, is to frame a bill in harmony with the interests
of the class to be benefited ; one that is not com-
pulsory in its application. No other form will
prove feasible or effective.
The form prepared and presented to the Legisla-
ture by Dr. Searle is as follows :
"An Act in Relation to the Practice of
Physic and Surgery.
" The People of the State of New York, repre-
sented in Senate and Assembly, do enact as fol-
lows :
" Section i. On or before the first day of May,
1 868, and thereafter from time to time as may be-
come requisite, the Governor shall nominate, and
by and with the advice and consent of the Senate,
shall appoint seven Doctors of Medicine, who shall
186
The Medical Union.
constitute a Board of Censors for the examination
of candidates for the degrees of ' Physician and
Surgeon ' and ' Physician.'
" § 2. One of said doctors of medicine shall be
appointed censor of anatomy ; one, censor of physi-
ology ; one, censor of surgery ; one, censor of
chemistry ; one, censor of obstetrics ; one, censor
of materia medica ; and one, censor of general pa-
thology.
" § 3. Each censor shall hold office for the term
of six years, and until his successor is duly qualified ;
and shall receive for his services the sum of two
thousand dollars per annum, to be paid him from
the treasury of the State. Any one of the censors
may at any time be removed by the Governor under
the provisions of the statutes relating to the removal
of sheriffs from office, which provisions are hereby
extended so as to relate to each one of the said cen-
sors.
" § 4. In case of death, resignation, inability to
perform the duties of the office, or from other
cause, the office of any censor becomes vacant, a
new censor shall be appointed for the unexpired
term. In case such vacancy shall occur during the
recess of the Senate, the Governor shall appoint a
censor to fill the same, who shall hold office during
the remainder of the unexpired term.
" § 5. Each State Medical Society may at all
times keep seven doctors of medicine in nomination
for the office of censor.
" § 6. Censors shall not receive, directly or indi-
rectly, any fees from any candidate.
" § 7. Each candidate shall be examined sepa-
rately, and by one censor only at a time. No can-
didate shall be subjected to any examination upon
therapeutics ; nor shall he be refused any of the cer-
tificates hereinafter provided for, by reason of any
views he may entertain upon the subject of thera-
peutics.
" § 8. The examination herein provided for shall
be conducted by written or printed question and
answer, and, if satisfactory to the censor making the
same, he shall furnish to the candidate a certificate
in writing, signed by himself, that such candidate
has passed a satisfactory examination, and said cen-
sor shall forward a duplicate of said certificate to
the Secretary of State. No candidate shall be re-
examined, after having been once rejected, until
after the lapse of one year.
"§9. Any citizen of this State, who has pre-
viously received the degree of Doctor of Medicine
from any legally authorized medical institution in this
State, or in any other State or country, and who shall
present to the Secretary of State satisfactory evi-
dence thereof, and who has passed successfully all
the examinations required by this act, as evidenced
by the certificates of all the censors hereby created,
shall receive from the Secretary of State a diploma,
signed by the Governor and Secretary of State, and
bearing the seal of the State, conferring upon him
the title and degree of Physician and Surgeon. In
case any such person shall present satisfactory
evidence of having passed successfully all the exam-
inations except that of the censor of surgery, he
shall receive from the Secretary of State, a similar
diploma, conferring upon him the title and degree
of 'Physician.' Each person receiving such a
diploma shall pay into the treasury of the State the
sum of fifty dollars.
" $ 10. All acts and parts of acts now in force,
so far as inconsistent with the provisions of this act,
are hereby repealed, but such repeal shall not revive
any former act.
"§ n. This act shall take effect on the first day
of May, 1868 "
Dr. Searle presented the following resolutions,
which were adopted :
Resolved, That the bill for the suppression of em-
piricism and the elevation of the standard of medical
requirements, entitled " An Act in Relation to the
Practice of Physic and Surgery," now pending in the
Legislature, meets our approval and endorsement.
"Resolved, That we request for it careful con-
sideration and early adoption by the Legislature of
this State."
On motion of Dr. Searle, a committee, consist-
ing of Drs. J. F. Gray, B. VF. Joslin, C. Dunham,
H. D. Paine, R. C. Moffatt and W. H. Watson,
was appointed to take action regarding the form of
a law proposed by himself, embracing such modifi-
cations as may be required, and to report at the
next annual meeting of the Society.
At the twentieth annual meeting of the Society,
held in February, 1871, the Committee on Medical
Education presented, through its chairman, Dr. J.
F. Gray, the following report :
"The Committee on Medical Education respect-
fully report the following form of a law, regarding
the examination of candidates for the license and de-
gree, as, in their unanimous judgment, the best
means this State Medical Society can adopt for the
advancement of sound practical knowledge among
the future members of the profession in the State of
New York :
In Assembly, February 17, 1871.
"An Act Concerning the Practice of Physic
and Surgery.
" The People of the State of New York, repre-
sented in Senate and Assembly, do enact as fol-
lows :
" Section i. In addition to the cases mentioned
in section twelve, of title seven, t>f chapter fourteen
of the first part of the Revised Statutes, the re-
gents of the University shall have the power of
granting diplomas, conferring the degree of Doc-
tor of Medicine, in the manner and under the
conditions following, viz. :
" 1. The regents of the University shall appoint
one or more boards of examiners in medicine, each
board to consist of not less than seven members,
who shall belong to some of the State or county
medical societies of this State.
"2. Such examiners shall faithfully examine all
candidates referred to them by the chancellor of
the University for that purpose, and furnish to the
chancellor a detailed report in writing of all the
questions and answers of each examination, to-
gether with the opinion of each examiner as to the
merits of the candidates in every case.
"3. Such examination shall be in anatomy, phy-
siology, chemistry, the history of medicine, the al-
lopathic and homoeopathic modes of practice, sur-
gery and midwifery.
"4. The said reports of such examination shall
be a part of the public documents of the University,
and the action of the -regents thereon shall accom-
pany the same.
The Medical Union,
187
"5. Any person over twenty-one years of age, of
good moral character, applying to the said chancel-
lor therefor, shall receive an order for such ex-
amination on satisfying the chancellor that he or
she has a competent knowledge of arithmetic,
algebra, the Latin and German languages and of
the Greek grammar, and on paying into the treas-
ury of the University the sum of thirty-five dollars.
"6. The regents of the University, on receiving
the aforesaid report of the examiners, and on find-
ing that at least five members of the board report
in favor of the candidate, shall issue to him or her
a diploma, conferring upon him or her the degree
of Doctor of Medicine of the University of the State
of New York, which diploma and degree shall en-
title him or her to practice medicine in this State.
" § 2. The candidate, on receiving the said dip-
loma, shall pay into the treasury of the University
the further sum of fifteen dollars.
" § 3. The moneys paid into^the treasury under
the provisions of this act shall be appropriated by
the regents toward paying the expenses of executing
the provisions of this act.
" § 4. The regents may, from time to time, estab-
lish and adopt such rules and regulations as they
may deem proper and necessary to carry out the
provisions of this act.
" § 5. This act shall take effect immediately."
The report was unanimously adopted by the pas-
sage of the following resolution, offered by Dr.
Searle :
"Resolved, That the Homceopathic Medical So-
ciety of the State of New York approves and in-
dorses the project of the bill, entitled, ' An Act
Concerning the Practice of Physic and Surgery,'
and respectfully requests the passage of the same by
the Legislature."
The following resolution, offered by Dr. Hough-
ton, was also adopted :
"Resolved, That the bill entitled "An Act Con-
cerning the Practice of Physic and Surgery " be re-
ferred back to the committee formerly having it in
charge, with instructions to take such action as may
be required to secure its enactment by the Legisla-
ture, and that Drs. Cox and Jones, of Albany, and
Searle, of Brooklyn, be added to that committee."
Copy of a memorial accompanying the proposed
act, signed by the president and recording secretary
of the Society :
Memorial accompanying the Bill.
" To the Honorable the Legislature of the State of
New York:
"The undersigned, in behalf of the Homceo-
pathic Medical Society, and by its direction, beg
leave to call the attention of your honorable body
to the annexed project of a law respecting the ap-
pointment of one or more boards of examiners in
medicine by the regents of the University, and to
ask that it may become a law, for the following rea-
sons, viz. :
"First. The existing colleges of medicine and
medical societies are not directed by law to require
of candidates for their diplomas any classical train-
ing whatsoever. Nevertheless, it is well known to
all physicians that, without considerable knowledge
of the Latin language, a thorough acquaintance
with arithmetic up to and including decimals of al-
gebra, and enough knowledge of the Greek gram-
mar to render reference to the lexicon of that lan-
guage an easy and satisfactory process, it is impossi-
ble for the student of medicine to read, with clear
comprehension, the elementary books of the art of
healing, or listen to the oral instructions of lectures,
without losing the connection very frequently, for
want of a knowledge regarding the technics used,
all of which are of Latin or Greek derivation, or
through ignorance 'of the definite relation of quan-
tity, expressed by decimal and algebraic notation.
For want of this preliminary instruction, the stu-
dent of medicine, whatever his industry or force of
intellect is, and however excellent his preceptors
may be, must be a confused and inexact scholar,
and, therefore, also become and remain an insecure
and uncertain practitioner of his art.
"Second. The existing colleges of medicine can-
not remedy this difficulty in any one State, if any
or all of them desire so to do ; for the refusal to re-
ceive all students who are deficient in these respects
could only result in turning all such applicants from
their doors, and, in effect, sending the majority
away to other States for instruction.
"Reformation of this great and growing evil
among existing colleges of medicine in this country
is attainable only through a unanimous compact
among them, shutting the doors of all to illiterate
applicants ; a result which may safely be considered
impossible, since the attempt would deprive all
alike of pupils and of the means of support for
some three or four years at very shortest.
" Third. The Homceopathic Medical Society of
the State, after mature consideration, appointed a
committee, a year ago, to ascertain in what way a
rule requiring a somewhat liberal education as a
preliminary condition of medical pupilage could be
established without infringing upon the legal rights
of existing medical colleges. Their committee re-
ported the plan proposed in the bill annexed, which
met with very favorable consideration in the society,
and which was this morning unanimously adopted
by that body, namely: the empowering of the
regents of the University to appoint boards of ex-
aminers, before which only liberally educated candi-
dates could appear and canvass for the license and
degree.
"Fourth. Your memorialists hope that the im-
partiality, or rather catholicity of the plan, whereby
each of the existing schools of practice can have
a board of examiners at the hands of the regents,
will meet the approbation of the government of the
State.
"Fifth. The method of examination, although a
somewhat tedious process, has been proven to be of
inestimable value in Prussia and Denmark, where it
has been in operation for more than half a century,
and produced highly desirable results in every re-
spect. It is to be hoped that the regents will make
rules respecting the making and keeping of the
records, which shall insure entire impartiality and
fullness of scrutiny on the part of the examiners.
"Sixth. If this bill become law, the very best
talent will be in requisition, and, at no distant day,
in harmonious competition throughout the State.
No special franchises will be needed, nor will they
be sought for ; voluntary associations of teachers
can do the good work under this general act, in a
1 88
The Medical Union.
far more efficacious and more republican, and,
therefore, more honorable manner than the present.
The undersigned have the honor to represent the
views of the homoeopathic physicians of the State
in this memorial, and to present the views to the
Legislature in behalf, and by specific order, of the
Homoeopathic Medical Society of the State, made
at the recent annual meeting of that body.
"Albany, February 15, 1871."
The committee readily awakened an interest in
the measure on the part of members of the Leg-
islature, through whose instrumentality its passage
was successfully accomplished. The bill was, how-
ever, vetoed by Governor Hoffman for reasons which
could easily have been obviated had the committee
been aware of the objections expressed by the Gov-
ernor to the phraseology of one or two sections of
the law.
At the semi-annual meeting of the Society, held
in August, 1 87 1, the subject was presented by Dr.
Gray, who spoke at considerable length regarding
the objects and merits of the bill, and correspond-
ence between himself and Governor Hoffman. He
offered the following resolution, which was unani-
mously adopted :
"Resolved, That the Committee on Medical Edu-
cation be instructed to change the bill passed by
the last Legislature, by making such modifications
(not impairing the purposes of the bill) as they may
find necessary, and take such action as may be re-
quired in order to secure its passage by the next
Legislature of this State."
At the annual meeting of the Society, February
13th, 1872, Dr. Gray presented the report of the
Committee on Medical Education, and said : " You
will remember, gentlemen, that your Committee on
Medical Education reported on a bill to establish an
advanced credential of honor, one being a trial of
merits of the higher kind, that is to say, a creden-
tial of honor to those physicians who had exhibited
proficiency in classics, medical education, and Eng-
lish education equal to the State Normal schools,
and who should have such qualifications ascertained
on an examination before the board of examiners
appointed by the University of the State, and he
should there receive the degree of Doctor of Medi-
cine from the University of the State of New York.
The bill passed both houses of the Legislature last
year, unanimously, but was returned by the Gov-
ernor for reasons which did not transpire to me.
At its last meeting, your Society directed the com-
mittee to make such modifications in the bill as
would secure its passage by the Governor. I have
seen him several times on the subject, and I called
the committee together, and we agreed upon the
modifications.
The first objection of the Governor was that it
conferred additional power on the Board of Regents,
whose powers were already too numerous. Where-
as it was not really such an increase of power, nor
an additional power of license. The Board of Re-
gents already possessed these powers, and had pos-
sessed them for half a century. On the contrary, it
was a limitation rather than an extension of prerog-
atives. Again, the Governor objected that the
labors of the censors would be too severe under such
an enactment ; that they would not be satisfied with
the fee of five dollars, and would draw on the trea-
sury of the State for further remuneration.
Dr. Gray then referred in detail to the differences
between the former and the amended bills, the lat-
ter having been drawn up in such a manner as to
avoid the Governor's objection, and, having been
unanimously adopted by the Bureau of Medical Edu-
cation, he hoped it would become a law.
Dr. Watson moved that this amended bill, as
drawn up by Dr. Gray, be adopted by this Society ;
also, that a committee be appointed to present it to
the Legislature, with the recommendation that it be
passed. The motion was carried. Drs. J. W. Cox
and E. D. Jones were appointed the committee.
On the 5th of June, 1872, the secretaries of the
State Society informed the American Institute of
Homoeopathy, then in session in Washington, by a
telegram to Dr. Gray, ex-president of the Institute,
that the bill creating a State Board of Homoeopathic
Medical Examiners had just been signed by the
Governor.
The bill was again presented to the Legislature
early in the session of 1872, and with it the memo-
rial previously prepared and offered by the presi-
dent of the society, Dr. Gray. Also, accompany-
ing these papers, there was furnished the medical
committees of the Senate and Assembly a copy of
the resolutions adopted by the Society, showing the
bill had twice received the unanimous indorsement
of the State Homoeopathic Medical Society, and
many of the county medical societies. There was
also furnished a copy of the following letter by Dr.
W. H. Watson, lucidly setting forth the objects
and provisions of the act, and the reasons for sup-
porting it :
ADVANCED MEDICAL EDUCATION ACT.
" This bill, sometimes called ' The Advanced
Medical Education Act,' is designed to elevate the
standard of medical education. Its objects and
provisions may be stated under two general heads.
" I. The object and mode of accomplishment of
the purposes of this bill. First. — Its object is solely
the elevation of the standard of medical education
in this State.
"Second. — It purposes to accomplish this by es-
tablishing a higher honorary degree for the medical
profession. The desire to obtain this coveted de-
gree will furnish an incentive to the ambition of
medical men, and will thus powerfully contribute to
a higher standard of scientific attainment among
the members of the medical profession.
" Third. — Its possession, while conferring no
special or peculiar privileges upon a class, will yet
be an assurance to the public of the superior quali-
fications of those who should obtain the proposed
degree, and will, therefore, become a legitimate
passport to professional success.
" 2. Its entire freedom from all objectionable fea-
tures. First. — In no sense does it embody prohibi-
tory legislation. Should this bill become a law, it
will not prevent any physician now in practice from
pursuing his profession as before, nor will it prevent
any person who may hereafter desire to enter the
profession from obtaining a license to practice from
any of the sources now authorized by law to confer
such license.
" Second. — Its provisions do not in any way con-
flict with the vested rights and privileges of the
medical colleges. It would, however, furnish an
inducement to them to increase the thoroughness
of their instruction and advance their standard of
The Medical Union.
189
graduation, since, in course of time, that institution
would attain the highest reputation from which the
largest number of graduates should attain the pro-
posed degree.
" Third. — It is entirely liberal and impartial.
Under its provisions each of the existing schools of
practice can have a board of examiners at the hands
of the regents^ should it be desired.
'•'Fourth. — Finally, no other means can be de-
vised which would so powerfully tend to the ad-
vancement of sound practical knowledge among the
future members of the medical profession in the
State of New York, while its liberal and entirely
catholic provisions leave no room for objections, and
commend it fully to the good sense of the people of
the State."
The form was modified several times to meet tl%e
objections raised by Governor Hoffman, and by
members of the medical committees of the Senate
and Assembly. It finally passed both branches of
the Legislature, and was signed by Governor Hoff-
man, May 16, 1872. The following is a copy of the
form finally adopted:
LAW AUTHORIZING THE APPOINTMENT OF
STATE BOARDS OF MEDICAL EXAMINERS.
Session Laws, Chapter 746.
"An Act Relating to the Examination of
Candidates for the Degree of
Doctor of Medicine.
"Passed May 16, 1872.
" The People of the State of New York, represented
in Senate and Assembly, do enact as follows :
"Section i. The Regents of the University of
the State of New York shall appoint one or more
boards of examiners in medicine, each board to con-
sist of not less than seven members, who shall have
been licensed to practice physic and surgery in this
State.
"§ 2. Such examiners shall faithfully examine all
candidates referred to them for that purpose by the
Chancellor of said University, and furnish him a
detailed report in writing of all the questions and
answers of each examination, together with a sepa-
rate written opinion of each examiner as to the ac-
quirements and merits of the candidates in each case.
"§ 3. Such examinations shall be in anatomy,
physiology, materia medica, pathology, histology,
clinical medicine, chemistry, surgery, midwifery
and in therapeutics, according to each of the sys-
tems of practice represented by the several medical
societies of this State.
"§4. The said reports of examinations, and the
annexed opinions of the examiners, shall forever be
a part of the public records of the said University,
and the orders of the chancellor addressed to the
examiners, together with the action of the regents,
in each case, shall accompany the same.
"§5. Any person over twenty-one years of age,
of good moral character and paying not less than
thirty-five dollars into the treasury of the University,
and on applying to the chancellor for the aforesaid
examination, shall receive an order to that effect,
addressed to one of the boards of examiners, pro-
vided he shall adduce proofs satisfactory to the
chancellor that he or she has a competent knowl-
edge of all the branches of learning taught in the
common schools of this State, and of the Latin lan-
guage, and that he has diligently studied medicine
not less than three years, under the direction of
one or more physicians duly qualified to practice
medicine, or has himself been licensed, on exami-
nation, by some medical society or college legally
empowered to issue licenses or degrees in medicine.
" % 6. The regents of the University, on receiv-
ing the aforesaid reports of the examiners, and
on finding that not less than five members of a
board have voted in favor of a candidate, shall
issue to him or her a diploma, conferring the degree
of Doctor of Medicine of the University of the
State of New York, which degree shall be a license
to practice physic and surgery.
"§7. The candidate, on receiving said diploma,
shall pay to the University the further sum of not
less than ten dollars.
"§8. The moneys paid to the University, as
aforesaid, shall be appropriated by the regents for
the expenses of executing the provisions of this act.
" § 9. The regents may establish such rules and
regulations, from time to time, as they may deem
necessary to insure the faithful execution of the pro-
visions of this act.
" § 10. This act shall take effect immediately."
State of New York, }
Office of the Secretary of State, 3 ss' '
" I have compared the preceding with the original law on
file in this office, and do hereby certify that the same is a
correct transcript therefrom and of the whole of said original
law.
"G. Hilton Scribner,
"Secretary of State."
At the semi-annual meeting of the Board of Re-
gents of the University of the State of New York,
held in Albany in the month of August, 1872, a
committee was appointed, consisting of the chancel-
lor, Hon. J. V. L. Pruyn, the secretary, S. B.
Woolworth, LL. D., and Hon. H. R. Pierson, to
take such action as may be required in order to
carry out the provisions of the law authorizing the
appointment of State Boards of Medical Examiners.
The committee prepared and issued a circular letter
to the officers of the three State Medical Societies,
of which the following is a copy :
" September 23, 1872.
' ' To the Secretary of the Homoeopathic Medical So-
ciety of the State of New York :
" Sir : — At the request of the Committee of the
Regents charged with the matter, I inclose a copy
of an act passed by the Legislature of this State, on
the 1 6th day of May last, ' Relating to the Exami-
nation of Candidates for the Degree of Doctor of
Medicine.'
" This act having been submitted to the regents
at their recent semi-annual meeting, the subject was
referred to a committee consisting of the chancellor,
regent Pierson and the secretary, who are directed
to report thereon to the board.
"I am requested by the committee to say that
they will be happy to receive any views or sugges-
tions which you may offer in regard to the subject,
and the best mode of effectually carrying out the
provisions of the statute.
" Yours, with great respect,
"John V. L. Pruyn,
Xi Chancellor of the University.''''
190
The Medical Union.
In reply to this circular the recording secretary
addressed the following letter to the chancellor. The
letter was afterward printed in the form of a petition,
and mailed to officers of nearly all the county Ho-
moeopathic Medical Societies in this State, the ob-
ject being to simply convince the Board of Regents
that the homoeopathic physicians of this State
unanimously desired that the provisions of the law
should be faithfully carried out with as little delay
as possible :
"Petition for the Appointment of a State
Board of Homoeopathic Medical
Examiners.
" Hon. J. V. L. Pruyn, Chancellor of the Board
of Regents :
"Dear Sir: — In reply to the circular of the
Committee of the Regents, we have only to say that
the Homoeopathic State Medical Society has already
fully discussed the law regarding examinations for
the degree of Doctor of Medicine, and has unani-
mously asked for the appointment of at least one
board of examiners.
" In addition, we beg leave to solicit very early
action on the part of the regents in execution of
the law, so far as the homoeopathic branch of the
profession is concerned. There are many young
gentlemen of liberal culture, engaged in the study
of medicine in the State, to whom the prize of this
advanced degree with its arduous conditions ought
to be made known, if possible, before making their
choice of medical colleges and other preceptors."
The above petition was signed by officers and ex-
officers of medical societies in the following coun-
ties : Albany, Broome, Cayuga, Chemung, Che-
nango, Columbia, Dutchess, Erie, Livingston,
Madison, Montgomery, New York, Niagara, Onei-
da, Ontario, Oswego, Otsego, Orange, Rensselaer,
Saratoga, Schuyler, Steuben, Wayne and West-
chester.
On the receipt of petitions from so large a num-
ber of the counties in this State, the chancellor
deemed it expedient to call a special meeting of the
Board of Regents, to be held November 12th, to
consider, among other items of business, the ap-
pointment of a homoeopathic board of medical
examiners.
As soon as the time for holding this special meet-
ing was made known to the committee, the follow-
ing form of a petition was distributed to all who had
signed the first one :
" Petition for Appointment in the State
Board of Homceopathic Medical
Examiners.
" Hon. J. V. L. Pruyn, Chancellor of the Board of
Regents :
"Dear Sir: — Having been recently informed
that a board of State homoeopathic medical censors
is about to be created by the regents of the Univer-
sity, in compliance' with a law passed by the last
Legislature, I respectfully recommend for appoint-
ment the names of the nominees hereto annexed."
The above petition was signed by members of
the profession in the following counties : Albany,
Broome, Cayuga, Chautauqua, Chemung, Chen-
ango, Columbia, Dutchess, Livingston, Montgom-
ery, Niagara, Oneida, Ontario, Orange, Oswego,
Otsego, Saratoga, Schuyler, Steuben, St. Lawrence,
Tioga, Ulster, Washington, Wayne and West-
chester.
On the day following the meeting of the Board
of Regents, the secretary, Dr. Woolworth, caused
the insertion of the following notice in the Albany
daily papers :
"University of the State of New York —
Homceopathic Medical Examiners
Appointed.
" Office of the Regents, Albany, Nov. 13, 1872.
" At a meeting of the regents of the University,
held at the Capitol, in the city of Albany, on the
1 2th day of November, inst., an act of the Legis-
lature, ' Relating to the Examination of Candidates
for the Degree of Doctor of Medicine,' passed May
16, 1872, which was laid before the regents in
August last, was again considered. An application
was received from the Homoeopathic Medical So-
ciety of the State of New York, for the appoint-
ment of a board of examiners, pursuant to the first
section of said act, which was supported by peti-
tions from twenty-six counties, in various parts of
the State. A delegation from the State Society also
attended the meeting.
"After full consideration of the subject, the appli-
cation was granted by the regents, and the follow-
ing board appointed: John F. Gray, LL. D., M.
D., New York, president of the board; Erastus A.
Munger, M. D., Waterville; Wm. H. Watson, A.
M., M. D., Utica; Henry B. Millard, A. M., M.
D., New York; Wm. S. Searle, A. M., M. D.,
Brooklyn; Horace M. Paine, A. M., M. D., Al-
bany; Henry N. Avery, A. M., M. D., Poughkeep-
sie; John A. McVicar, A. M., M. D., New York;
Samuel A. Jones, A. M., M. D., Englewood.
The board of examiners has perfected an organ-
ization, by electing Dr. John F. Gray, of New
York, president of the board and Dr. W. S. Searle
secretary. The examiners in the several depart-
ments specified in the law have been designated,
and a committee has been appointed to draw up a
circular letter, addressed to the medical profession,
setting forth the code of procedure under which
provisions of the statute may be made practically
effective. A meeting of the board will be held in
conjunction with the annual meeting of the State
Homoeopathic Medical Society.
WHAT THE LAW IS DESIGNED TO ACCOM-
PLISH.
The features of this law are new and peculiar. It
aims at the ultimate accomplishment of a radical
change in the present system of medical education.
It attempts to establish a higher plane toward which
the teachers of the present day must inevitably pro-
gress. As has been freely admitted in the report
previously quoted, "the degree, as now conferred,
is nearly valueless as a title to confidence." This
law has been framed for the purpose of creating a
degree which will possess positive value; one which
will indicate that its possessor is thoroughly instruct-
ed in all the essential departments of medicine and
surgery. It has erected checks and safeguards to
insure the faithful execution of its own provisions.
Chief among these is the mode of examination which
is to form a part of the records of the board of re-
gents, open to inspection at any time, by any mem-
ber of the profession.
The Medical Union.
191
Another important feature is the requirement re-
garding a thorough preliminary education. The
law requires of the applicant "a competent knowl-
edge of all the branches of learning taught in the
common schools of this State, and of the Latin lan-
guage." It will be observed, on examining the
form first presented to the Legislature, a knowledge
of the Greek and French or German languages was
required. This provision was omitted in the second
bill on account of objections to it by members of the
medical committee of the Assembly. If it shall be
deemed expedient to restore these requirements, it
can be readily, accomplished at some future time.
Another element of strength is its non-sectarian
character. Each applicant is to be examined upon
all the recognized systems of medical treatment.
This feature distinguishes the examination from
that established by any other board in this or any
other country. The method adopted by the Ontario
board of examiners is the nearest approach to it.
In that board the candidate is permitted to select
one of three systems of therapeutics in which he
desires to be examined.
Another and most important feature is the
separation of the teaching from the licensing inter-
ests. The candidate is permitted to obtain a knowl-
edge of medicine and surgery from any and every
source within reach. The object designed to be
attained by this board is to put on permanent
record the evidence of the qualifications of candi-
dates for the degree. The right to confer the de-
gree of Doctor of Medicine is now, and for many
years will be, entrusted to those chiefly who are en-
gaged in teaching. While this plan has many ad-
vantages it has many defects. To it are traceable
many of the evils under which we are now laboring.
In the report of the committee before mentioned,
this feature is referred to in these forcible words,
"and last, though not least, that evil so long and
so generally complained of, the union, in the same
body, of the office to teach and the power to li-
cense." Those who have thoroughly investigated
this subject are convinced that an improvement
cannot be anticipated until the licensing power is
exercised only by a body having no personal inter-
est in the success of the candidate. It is not prob-
able that such an independent body of men would
be disposed to confer the privileges of membership
in the profession on unworthy candidates, or be in-
fluenced, to any considerable extent, by pecuniary
or selfish considerations.
It is eminently fitting that the licensing board
should have an organization independent of, and
distinct from, the medical schools ; and, that its
members should be recommended and nominated
by the medical societies ; also, that they should be
appointed by, and constitute a part of, the educa-
tional department of the State government.
Functions of the Spleen. — Professor Baculi,
of Rome, in a recently published work on " Perni-
cious Fevers," develops the theory that the spleen
is an organ, which, connecting itself by the abdomi-
nal system of veins with the stomach, pancreas and
liver, has for its function to utilize the hydro-car-
bons, while the pulmonary venous system eliminates
them. — Medical World.
Reuieuis of Boohs,
Among other monographs, reports and reprints,
by Dr. J. N. Pooley, of Yonkers, we are in receipt
of two valuable papers on Imperforate Anus; the
latest of which, with full citations from its surgical
history, in conjunction with the Doctor's experience
and practice, is a concise essay upon the recto-vagi-
nal forms of this congenital malformation.
Though but a 36-page pamphlet, it is a nearly
exhaustive paper, and a lucid expose of the contin-
gencies in these interesting cases, which, though
rare, may present themselves to the practising
physician at any moment for cure and correction.
Published by William Wood & Co., New York.
Scientific iBleanincjs*
Development of Cancer of the Skin. —
Carmalt, from an examination of three carcin-
omatous tumors removed from the skin, comes to
the conclusion that the epithelium of hair follicles
is the point of departure of the cancerous growth ;
and this, he thinks, throws some light on the cause
of cancer of the skin. Referring to the statement
of Fiilmor that frequent and rough shaving is apt
to produce cancer of the skin of the face, he points
out that out of fifty or sixty cases of cancer of the
lip and cheek that have occurred within a recent
period in the Breslau Pathological Institute, only
two were in women, and not a single case occurred
in men with unshaved beards. With reference to
the general question of the histological origin of
cancer, his conclusions are, so far, in support of the
opinions of Waldeyer and others, that every cancer-
ous growth originates in the epithelial elements of
the part, and are in opposition to the opinion of
Virchow, that the cancer cells are the equivalents of
connective tissue corpuscles. — London Medical Re-
cord.
Clinical Means of Recognizing Mercury
in the Excretions. — M. Mayencon and Dr.
Bergeret, in an interesting paper on this subject,
give the following as the conclusions at which they
have arrived: 1. That mercury and its salts are
absorbed by the skin as well by the stomach. 2.
That of the mercury absorbed, a part, and that the
major part is immediately eliminated, while the
smaller part impregnates the tissues, from which it
is only insensibly eliminated. Even this part,
however, is rather quickly eliminated if the use
of the medicine has not extended over any great
length of time. 3. Elimination seems to be effected
by all the excrementitious fluids, but chiefly by the
urine and the intestinal juices. 4. Iodine has a
marked effect in clearing away mercury from the
tissues. 5. Mercury, and mercurial preparations,
discharged by the humors, and especially by the
urine, are readily discoverable by the action of a
voltaic element, iron and platinum. The mercury
forms a metallic coating on the platinum, and
should then be converted into the bichloride, and
finally into the red biniodide, with a solution of the
iodide of potassium. — Robin's Journal d1 A natomie,
No. i, 1873.
192
The Medical Union.
Precautions Against Venous Hemorrhage
in Tracheotomy. — Dr. Frederick Betz, of Heil-
broun, in his Memorabilien, observes that venous
hemorrhage constitutes one of the most fatal occur-
rences in tracheotomy. It may occur either before
or after the incision into the trachea. If it occur
before it may be averted by the application of ses-
quichloride of iron, by transfixion of the vessel and
the application of a ligature, or, still better, by
the rapid introduction of a canula and the re-estab-
lishment of the respiration. In like manner, if the
hemorrhage occur after the incision into the trachea,
the insertion of the canula is the best, and indeed
the only means of stopping the bleeding. There are
cases, however, in which, notwithstanding that the ca-
nula has been skillfully inserted, hemorrhage con-
tinues, because the child makes no inspiration, but
remains in a state of spastic expiration. In such
condition respiration should be excited by blowing air
through the canula. Dr. Betz has performed fifteen
tracheotomy operations in croup, with six recoveries.
In one case the child died on the table from
asphyxia, but in a similar case, which occurred
subsequently, recovery took place by employing the
above means. The great distension of the cervical
veins during expiration is well known, and the
hemorrhage, if a vein be wounded, is then very free
on this account. Dr. Betz recommends that the
incisions should be made, as far as possible, during
inspiration. — Aerztliches Literaturblatt, No. 16,
1872.
A New Ligature. — Professor Dittel recently in-
troduced, at a meeting of the K. K. Gesellschaft der
Aerzte, a new ligature, which he advocated in the
most enthusiastic manner. It is, in short, a com-
mon rubber drainage tube which differs, of course,
in calibre according to the requirements of particu-
lar cases. As yet he has only used it in cases like
the following: A "mother's mark," on the right
temple of a five months' old child, was ligatured.
The tumor fell off in eight days, leaving a clean
granulating wound. It was applied with success to
the following arteries : the popliteal, after amputa-
tion of the thigh ; the anterior tibial, after Pirogoff's
operation; the posterior tibial and peroneal art-
eries. The principal advantages claimed for the
new ligature are that it exerts an equable and con-
tinuous pressure on the part, most perfectly con-
stricting it, requires but one application, and does
not excite any discharge of pus. It is not neces-
sary that a tube should be used ; any elastic cord
will answer. Professor Dittel says, as yet his ex-
perience with the new ligature is necessarily small,
but he will shortly publish more results, demons-
trating its superiority over all other constrictors.
[The above is from a private letter to the editor.
Professor Dittel may gather more facts about the
elastic ligature by applying to Mr. Lee, of London,
who has used the elastic ligature for years, and first
introduced it to the profession. It is a very good
ligature, especially for naevi, and will do for other
things when the ordinary ligature is not at hand. —
J. C. M.]
Sea-Sickness.— Dr. De Douche (Liverpool
Medical and Surgical Reports) attributes the con-
tinued retching in this affection to the very acid
condition of the secretions of the stomach ; he finds
that if alkalies, combined with aromatics, are given,
it will generally yield. Anaemia of the brain is the
supposed cause of the giddiness. — Medical Record.
Cure of Lipomata by Alcoholic Injections.
— Dr. Hasse, of Nordhausen (Blat. fur. Heilk.
1872), has tried the practice of alcoholic injections
in fatty tumors, at the suggestion of Dr. Schwalbe,
of Zurich, and with excellent results. One case
was that of a lady with a large lipoma on the
shoulder, extending into the axilla. The patient
desired excision, but her health contra-indicated the
operation Dr. Hasse made, in four sittings, at in-
tervals of about fourteen days, injections with the
ordinary spirit used for burning, with a small gutta-
percha syringe. The contents of said syringe was
put into different parts of the tumor. The reaction,
at first, was very slight, but increased at next reac-
tion, and was again resumed when the reaction
became milder. First of all the tumors became
more consistent, but softening followed, and finally
fluctuation appeared in some points which extended.
When an incision was made into the tumor in three
weeks, the fatty contents flowed away in a fluid state,
the exudation of the last part being aided by slight
pressure. The patient could follow out her occupa-
tion of teaching during the treatment. In a second
case, in a gentleman, aet. 40, three injections had
been made, with four or five weeks interval. The
reaction was but slight in this case.
Weuis 3iem$*
University of the State of New York. —
State Board of Medical Examiners. — A
meeting of the Board was held at the Delavan
House, in the city of Albany, yesterday, July 29th.
A code of rules for the government of the Board,
also to give practicability to the provisions of the law
by which it is established, were reported and referred
to the Board of Regents for approval. Two or
three changes in the membership were also made,
by which a quorum can now be easily obtained in
the city of New York. These changes were rendered
necessary by the inability on the part of several mem-
bers to regularly attend the meetings of the Board.
The members of the Board as at present consti-
tuted, are John F. Gray, M. D., LL. D., President;
Dr. Horace M. Paine, Secretary; Dr. George E.
Belcher, Dr. Henry B. Millard, Dr. William H.
Watson, Dr. William S. Searle, Dr. John C. Minor,
Dr. J. A. McVickar, Dr. Samuel A. Jones.
The departments established are the following :
Dr John F. Gray, Institutes of Medicine ; Dr. John
A. McVickar, Homoeopathic Materia Medica and
Therapeutics; Dr. John C. Minor, Surgery and
Anatomy; Dr. Henry B. Millard, Allopathic Mate-
ria Medica and Therapeutics; Dr. William H.
Watson, Pathology and Diagnosis ; Dr. George E.
Belcher, Clinical Medicine ; Dr. William S. Searle,
Obstetrics; Dr. Samuel A. Jones, Histology and
Physiology; Dr. Horace M. Paine, Chemistry.
The code of procedure and the rules for the gov-
ernment of the Board will be published in a few
weeks in pamphlet form, for general distribution
to the profession throughout the State.
Dr. J. Titus Deyo, House Physician to the
"Western Homoeopathic Dispensary," located at
41 1 and 413 West 42 d Street, favors us with the fol-
lowing semi-annual report of that institution:
" There have been treated during the six months
ending June 30th, 8,017 patients — 6,792 in the
House Department, and 1,225 in the Visiting De-
partment. Thirteen deaths occurred."
The Medical Union.
193
Original Articles*
CHOLERA IN NASHVILLE.
ITS CHARACTER, TREATMENT AND RESULTS.
By J. P. Dake, M. D.
Since the appearance of cholera in this city, hav-
ing received many letters from different parts of the
country inquiring as to its characteristics and treat-
ment, and finding myself unable to answer them
individually, I seek to give the desired information
through your wide circulating columns.
ITS FIRST APPEARANCE.
During the latter part of May we were advised of
the prevalence, at Memphis and along the Missis-
sippi River, of a form of cholera morbus, quite
sudden, rapid and fatal. Although the press, and
even the physicians, hesitated to call the disease
cholera, I was satisfied it could be nothing less,
from information afforded me by Dr. Morse, of
Memphis. About the 1 st of June cases of the same be-
gan to occur in our city, increasing steadily in num-
ber up to the 20th, and then decreasing so as to be
nearly all gone by the end of the month.
ITS CHARACTERISTICS.
The disease differed from Asiatic cholera, as seen
in years past, only in having, in most cases, bilious
evacuations in place of the peculiar " rice-wa-
ter." Generally there were first greenish, wa-
tery dejections, then vomiting of ingesta and bil-
ious matter, followed soon, if not relieved, by
collapse, with the usual cold surface and extremi-
ties, and blue, shriveled skin.
If the evacuations continued long unchecked,
they sometimes became purely rice-water, but in
many cases they were bilious to the last. In not a
few cases the dejections were entirely rice-water.
Cramps in the abdominal muscles, and in those
of the extremities and other parts, were present in
nearly all severe or fatal cases.
On account of the bilious evacuations, many phy-
sicians hesitated to pronounce the disease cholera,
and hence it was often termed " The Prevailing,"
" The Epidemic," etc., in our newspapers.
Different theories were put forth regarding its
origin and nature. Some regarded it as of mala-
rial origin and type, and many as produced by the
peculiar properties of the vegetables in use, the
spring having been unusually late and the vegeta-
bles less matured than usual, at the season they
were brought into market. And the accumulated
filth in the streets, alleys and yards of the city was
blamed for the terrible scourge.
I have observed and studied the disease in its dif-
ferent phases and stages, and candidly confess, that
its specific or essential cause is yet unknown.
No theory brought forward covers all the facts
\ in the case — none is entirely satisfactory and relia-
f ble. '
The disease is not a "congestive chill;" it has
attacked many not using the "immature vegeta-
bles," and it has invaded the cleanest parts of the
city, some of the best kept homes, where there
could be no " accumulated filth."
I have not hesitated to pronounce it cholera, and
of a character as epidemic as it is has generally
been, on former occasions, in this country. The
evacuations, especially in persons of a bilious tem-
perament, were at first bilious necessarily, because
it was at a season when bilious diarrhoea would be
prevalent, if ever, and when people could scarcely
have any unusual evacuations without exhibitions of
bile.
In regard to the causes of cholera, I may repeat
what I wrote nearly twenty years ago, after a care-
ful study of the subject during the great epidemic
at Pittsburgh. In the production of a case of chol-
era there must be three causes simultaneously bear-
ing upon the individual, viz :
1 . A predisposition to the disease.
2. A specific cause, more or less prevalent ; and
3. An exciting cause.
An individual may have a predisposition to such
affections of the stomach and bowels, an irritability
or a weakness in the alimentary canal ; and he may
exercise, or eat, or drink imprudently, and bring on
diarrhoea or cholera morbus ; but he cannot have
cholera unless he is the subject of the specific pre-
vailing cause of that disease.
Or an individual may have the predisposition, and
be under the influence of the specific prevailing
cause, and yet have no cholera; indeed, he cannot
have it till the exciting cause is added.
Or, again, an individual may be subject to the
specific cause of cholera, and may encounter a very
sufficient exciting cause, and yet escape, if he has
not also an individual predisposition to such an affec-
tion.
As a familiar example of what I mean, I may say,
that in the production of effervescence at the soda
fountain, three causes are requisite — an acid, an
alkali and water — and that the absence of either one
would defeat the end desired.
The alkali and the acid, in a dry state, might
dwell together for years, without the least efferves-
cence; but the moment water is added, activity
begins. Or the alkali and the water might gently
mix, and remain quietly together till the acid is
introduced. Or the acid and water could exist in
combination for any length of time without efferves-
cence, till the alkali is added.
ITS AVOIDANCE OR PREVENTION.
Aside from the general cleaning up of the streets,
alleys and yards of the city, the spreading of lime
and coal tar, and an ordinance prohibiting the sell-
ing of all vegetables in the market, save onions !
and tomatoes, no public or general measures were
taken for the prevention of cholera.
Whether any, or just how much, good was effect-
ed by the efforts at cleaning and disinfecting and
the prohibitory ordinances, none can tell.
One fact was very plain, as it had been in former
visitations of cholera, that people who drank from
springs of strong lime-stone water, or wells of the
same, were more subject to the disease than those
using water from the river. And I may add, that
those using good cistern water were more exempt
than those using the river water, especially where
the latter was not filtered.
From my own observations, lately as well as for-
merly made, and from my views of the causation of
194
The Medical Union.
cholera, I specify the following as the most import-
ant precautionary or preventive measures :
i. A cool sponge bath and brisk dry rubbing of
the entire person every morning, on rising.
2. Usual avocations, moderately pursued.
3. Avoidance of unusual fatigue or exposure to
heat or cold, especially to currents of night air.
4. Avoidance of large draughts of cold water;
also of food difficult of digestion, such as cucum-
bers, cabbage, green corn, onions, green beets and
beans, fresh fish, the flesh of young animals, eggs,
rich pastry, candies, etc.
5. Avoidance of alcoholic drinks, especially of
beers fresh made. Light still wines, such as the
Catawba, Ives' Seedling or Concord, may be used
moderately at or after meals with benefit.
6. The best articles of food generally, during the
prevalence of cholera, are beefsteaks, rare-broiled ;
beef, rare-roasted ; mutton chops, broiled ; good
light bread, plain corn bread, " beaten biscuits,"
crackers ; potatoes, full-grown, well boiled or roast-
ed and thoroughly mashed ; tomatoes, fully ripe,
well stewed with light bread or crackers ; hominy
and rice, well cooked ; Japan or black tea, cistern
or freestone water, moderately ; very little milk or
cream.
Of course, general recommendations, such as I
am able to give in a popular article, cannot suit
every individual case.
Some of the articles allowed may disagree with a
person here and there, invariably, and such a one
should not therefore touch them. And some that
are prohibited may be in nowise hurtful to cer-
tain individuals, and they may use them with im-
punity.
In the prevention of cholera or any other disease,
the first duty of an individual is to lessen the predis-
position to it by an increase of the power of resist-
ance in the organism. This must be accomplished,
as I have already indicated, by proper bathing, ex-
ercise and diet.
The second duty is, to avoid exciting causes, ex-
cesses, in eating and drinking, and exercise, or im-
prudence in the same. Fear is a very great exciting
cause, and cannot easily be allayed. Where it has
taken very full possession of an individual, if pos-
sible there should be an immediate change of resi-
dence to a region not infested by the disease.
The third duty is, to prevent, by anticipation, the
inroads or attacks of the specific prevailing cause of
the disease.
In the avoidance of the loathsome small-pox, we
have learned to anticipate, and so prevent the ac-
tion of its specific cause, by the use of vaccine
virus.
And so in scarlet fever, we have found a valuable
preventive or modifier in belladonna.
And I am happy to say that there is also, acting
upon the same principle, a preventive, a prophy-
lactic, for cholera.
As the vaccine virus acts upon the organism,
through the blood, in the same direction and in a
manner similar to the genuine variolus matter ; and
as belladonna acts upon the organism, the mucous
membrane, the skin and other tissues, in the same
direction and in a manner similar to the genuine,
scarlatinal influence, these remedies exhaust the sus-
ceptibility of the organism to small-pox and scarlet
fever, more or less effectually and for a longer or
shorter time.
And precisely upon the same principle, and just
as successfully, does cuprum metallicum (copper),
properly prepared and used, exhaust the suscepti-
bility of the organism to the specific cholera influ-
ence.
I have given it to thousands of persons during
the prevalence of cholera in 1849, 1850, 1854 and
1873, as a preventive, and have never known one
of them to take the disease while under its influ-
ence. It has been successfully employed in Eu-
rope, North, Central and South America as a pre-
ventive. Statistics in its favor are abundant.
Dr. Burq, a distinguished French physician (allo-
pathist), discovering that the operatives in copper
works were almost universally exempt from cholera,
when prevalent all around them, corresponded with
the heads and managers of such establishments, in
various parts of the world, and, in a learned paper
on the subject, advocated the use of copper (cup-
rum) as both a preventive and curative agent in
cholera.
ITS CURE.
If, after all possible care, there is a concurrence
of the causes we have mentioned, and the suscepti-
bility of the organism takes in the cholera influence,
all must be anxious to know something of the nec-
essary means of cure.
Remedies must be suited to the various forms and
stages of the disease. And before proceeding to
mention the remedies best suited to the different
forms and stages of cholera, 1 must mention some
very commonly and most unsuccessfully employed.
Opium, in some form, is found in nearly every
mixture and prescription for cholera, and yet it has
no property or power making it a remedy for that
disease. Because it has sometimes checked simple
diarrhoea and may induce insensibility to pain, it
has been clung to as a sheet anchor in the treatment
of the terrible cholera, over which it can have no
possible control. Under its strong influence there
is depressed nervous and vascular action where there
should be exalted action, and a stagnation of blood
in the capillary vessels, where there should be a
brisk return, and thus by it a tendency to collapse
is established and harm done.
Pepper, Ginger, Mustard, one or all, may be
found in nearly every cholera mixture in common
use, notwithstanding they have no curative power
in cholera whatever. In the stomach and intestinal
canal they heat and burn the lining membrane and
adjacent tissues, till nature sends there all the fluids
she can muster to "put out the fire." The serum,
already leaving the blood to coagulate in the capil-
laries and veins, making the hands purple with the
coming collapse, is thus poured into the alimentary
canal and rushed more rapidly away.
Calomel, chiefly employed to substitute bilious for
rice-water evacuations, has been widely used and
most unsuccessfully. In 1 830-1, it was employed
and abandoned — praised and denounced alternately
the same in 1849, 1854, 1856, and I may add, in
i873-
Here in Nashville it has most signally failed, and
its advocates have been nonplussed by the glaring
fact, that scores of people have died with cholera,
whose evacuations at first, if not all the time, were
bilious.
Quinine has been brought forward and here ex-
tensively employed both as a preventive and a cur-
ative agent in cholera, upon the crazy hypothesis,
The Medical Union.
195
that the disease is but a form of intermittent fever —
"a mis-located, congestive chill."
It has been given by the spoonful to those want-
ing a preventive, and heads have reeled and ears
have rung with its fever-begetting stimulus.
And it has been injected under the skin, and its
unfortunate subjects have died from its poisonous
effects with few exceptions.
But let us turn to something more rational and
effective.
The principle upon which we must select reme-
dies is not essentially different from that upon
which we have obtained efficient preventives for
disease.
As belladonna is a curative agent in scarlet fever,
and cuprum in cholera, so must all agents be cura-
tive only as they bear a like relationship to the
affections for which they are severally employed.
As I have stated, belladonna cures scarlet fever
because it is capable of producing similar conditions
or symptoms.
For the same reason cold water cures cold feet,
lime-water and linseed oil lotion cures burns — by
exciting a curative reaction in the forces of nature.
Nature must do the curing, if any is ever effected.
All that medicine can do is to arouse or excite her
powers in the proper direction. Nature resists the
cold application to the feet, by sending more blood
and heat there, and so the cold feet are made warm.
(Lest persons, seeing the names of the remedies
I shall mention, be induced to go for such as they
can find in ordinary use, and so get crude or large
and poisonous doses, I will state distinctly that they
must be obtained only of dealers in homoeopathic
medicines.)
Croton Tig. is the remedy for diarrhoea, when
the discharges are copious, gushing and light colored.
Arsenicum Alb. — When the discharges are
copious, thin, of various colors, generally dark, very
offensive, attended with great thirst, or nausea and
prostration.
Veratrum Alb. — When the foregoing remedies
fail to stop the dejections, and when there is vomit-
ing sudden and violent, especially on taking cold
drinks or moving, with great weakness and faintness.
Cuprum Met. — When, with or without any of
the symptoms above given, there are cramps in the
muscles of the abdomen or limbs, or in the stomach.
This remedy may be used at any stage of the dis-
ease in alternation with one of the other remedies
named. In alternation with Veratrum it has effected
immense good.
Camphor. — When, during the prevalence of
cholera, one has a feeling of chilliness or sudden
prostration, with nausea and faintness, take three
drops of the tincture every fifteen or twenty minutes
till relieved. Also, if, after the use of other remedies,
there is a tendency to collapse, with cold surface and
extremities, feeble or faltering pulse, life may be
saved by the use of three drops of camphor every
fifteen minutes, alone, or, if needed, in alternation
with Cuprum or Arsenicum.
In regard to camphor, I must say that it has
saved more lives, in jeopardy with cholera, than any
other one remedy in the world. Wherever calomel,
\ opium and camphor have been given in mixture, all
the good effected in cholera has been due to the cam-
phor ; and the same might be said of all the other
prescriptions and mixtures for that dreaded disease
in which camphor has been a part.
ITS RESULTS.
The number of deaths from cholera here is not
exactly known. It has been variously estimated at
from 700 to 1,000. From the best information I can
gather, I believe it to have been not over 900. Of
this number, at least two-thirds were colored.
As the colored population here is only one-third
that of the white, say 12,000, in a total of 40,000,
it will be seen, that from some cause, or causes, the
disease was both more prevalent and more fatal
among them than the whites.
One cause was, doubtless, a greater predisposition
to the disease, by reason of temperament and con-
stitution, and another, their manner of living —
green and poorly cooked vegetables being their
chief subsistence, and limestone water their only
drink.
Their settlements are almost invariably about the
large limestone springs where the water is free from
tax, their cabins huddled together, illy constructed
and very damp.
In regard to remedies they went to extremes,
taking either none at all, or very large doses of de-
structive mixtures.
Nursing among them was very poor, the attend-
ants exercising more in frantic Drayers, singing and
shouting, than the timely faithful care required.
I must enter a protest here against the charge
appearing in many papers, that Nashville was more
grievously affected than some other cities, by reason
of local causes, general unhealthfulness, and a lack
of sanitary care. This city, on the score of general
healthfulness, is not surpassed by any city in the
United States. From July 1 to January 1, its in-
habitants have less sickness than the people of any
city that I am acquainted with, and from January 1
to July 1, it has only the troubles incident to changes
of temperature, save in June, when the first fruits
and vegetables come into use.
Nashville is distinguished for the salubrity and
mildness of its atmosphere.
There is no reason for severe visitations of cholera
here save, as I have mentioned, in its springs and
wells of limestone water, and the manner of living
among a portion of its population.
So far as modes of treatment, or remedies are
concerned, I have already indicated some of the
results.
Among the masses, the cry at first was for power-
ful remedies and large doses, but before the close of
the visitation it was changed. Thinking people with
facts before them, could not be long in coming to
the conclusion, that massive doses of poisonous drugs
not only failed to stay the disease in its fatal prog-
ress, but that they actually carried off with brain
disease and fever many whose good powers of endur-
ance had brought them through the cholera. Many
learned the truth couched in the words " die milde
macht ist gross" and turned for safety and relief
to the gentle doses of cuprum, veratru?n and camphor.
I am' satisfied that the rate of mortality under
homoeopathic treatment was not half what it was
under the allopathic.
In a practice that kept me busy eighteen out of
twenty-four hours, with a due proportion of cholera
cases, I lost but one patient with cholera.
I do not mention this fact for personal gain, nor
the success of homoeopathy for partisan purposes,
but in proof of the efficiency of the remedies point-
ed out by the homoeopathic principle, and in justice
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to medical science, and for the good of the people
of all classes and everywhere. The course of cholera
is onward to the north, east and south of us, and I
hope what I have written may prove of benefit to
those who may be in its sad line of march.
Nashville, Aug. 19, 1873.
A PRACTICAL CASE.
By R. W. Martin, M. D.
M. H., aged twenty-four, school teacher, dark
complexion, dark hair, dark eyes, emotional, good-
natured, although inclined to melancholy, consulted
me January nth, 1873, for a " weakness " of the
eyes causing her much trouble and pain.
After reading a few minutes, the letters and words
of the printed page would appear blurred, running
into each other, and presenting the appearance of
indistinct and cloudy lines ; at the same time a pain
would dart through the eyes from one temporal
region to the other, sometimes from right to left
and sometimes from left to right.
Generally she felt well and strong, but could
bear no fatigue and ^lways felt very much averse to
getting out of bed in the morning.
Menstruation was "conducted" regularly and
normally.
A profuse leucorrhcea was present, causing much
annoyance ; it was watery, acrid, offensive in odor
— the acridity so great as to destroy the linen gar-
ments wherever it touched them. The quantity
was such as to cause surprise ; as much as half a
tea-cup full, or about two fluid ounces, being dis-
charged every two or three hours during the day,
while at night there was no discharge, and not an
extraordinary quantity immediately after rising in
the morning. This leucorrhcea was always worse
immediately before and after the menstrual flow,
which, as I have before remarked, was perfectly
normal in quantity, quality and period. As she
seemed to be more particularly distressed about the
state of her vision, I refused to prescribe until an
expert ophthalmic surgeon had made a diagnosis.
Accompanying her to the clinic of Prof. C. T.
Liebold, at the N. Y. Ophthalmic Hospital, she
received a careful examination at the hands of that
skillful gentleman, whose verdict was "debility of
the internal recti muscles," the muscular astheno-
pia of Von Carion. The professor advised the con-
tinued use of cimicifuga.
After a faithful administration of this remedy for
two weeks and no improvement being manifest, I
gave Nitric ac. 3. This in turn was followed by
Creosote 3 to Creosote 30 without any apparent
benefit, but, on the contrary, the morning debility
had become excessive, and the pain in the eyes
came without the provocation of reading, while the
leucorrhcea had become even more fetid and corro-
sive.
March 2d. She received Iodine 30, a dose night
and morning.
March 9th. No better, and received Iodine 6,
carefully prepared on the centesimal scale.
March 16. No improvement being apparent, she
received one drachm of a tincture of Iodine, made by
dissolving 10 grains of that substance in one fluid
ounce of alcohol. Of this she was ordered to take
one drop three times a day in milk.
Improvement began to be manifest in three days;
the leucorrhcea first became less "marked" in its
odor ; then it became less acrid ; next, it was ob-
served that the quantity lessened and the "gushes"
were not so frequent.
The menstrual period came around, and after the
flow ceased, the leucorrhcea was worse than ever,
except that it was odorless ; she grew discouraged.
I ordered the Iodine to be taken every four hours,
and when the next menstrual period arrived, she
had neither leucorrhcea, or weak eyes.
The order of disappearance of the morning debil-
ity was not observed, but vision improved in exact
ratio with the disappearance of the leucorrhcea.
She has gone back to her old vocation of school
teaching with a more elastic feeling than she has
experienced for years, and no longer harassed by
the fears of one year ago, that she would never
more engage in the occupation she had chosen for
a life work.
And now let me ask some of the older and wiser
men of the profession; why, if there is "no choice
in the potency, provided you have the remedy,"
did not either of the higher potencies of Iodine
effect a cure ?
Every journal of our school comes laden with
cures made by the one-thousandth or the one hun-
dred thousandth potencies of drugs, and very often
of articles of food — as Triticum, Saccharum off., sac
cui flos ademptus est (why not add gus to the
materia medica) and others of the same stripe, while
sandwiched between them, we find occasional out-
bursts of invective against the dominant school for
its "unjustifiable trifling with human health and
life."
To me the only difference between the "unjusti-
fiable trifling" of the one school and the "unjusti-
fiable trifling " of the other school, is one of degree
only; just the difference between plus and minus;
between doing too much and doing too little.
Men holding extreme positions on all questions
of the day, be they political, theological or medical,
have always existed and will always exist. The sole
desire of these extremists, " Radicals " they like to be
called, would seem to be to carry the exemplifica-
tion of their peculiar views as far as possible — fur-
ther than most men of average ability can follow.
We have many of them in our school (need I say
the Homoeopathic), and among them, a few who
would hesitate not a minute to trust the life of a
patient to the thirty-millionth potency of moonshine,
were it attainable, and did it appear to be indicated.
That this is not all mere assertion will be appa-
rent to any one who will take the trouble to recall to
memory the odo-magnetic sugar man, with his
bottled blue-light, the transcendent virtues of which
were vouched for by one^ at least, of our brightest
lights whose illumination of many fields of scien-
tific research command our respect and admiration.
These reflections from the question asked constitute
my apology for inflicting this paper upon your
readers.
Elizabeth, N. J.
Prof. Agassiz has been presented with a hand-
some yacht of 80 tons, estimated to cost $20,000.
The vessel will be used for dredging, temperature,
soundings, &c, along the coast. Its presentation
makes perfectly complete the apparatus for practi-
cally training the students of the finest Natural His-
tory School in the world.
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197
THE "SCHOOLS" OF MEDICINE.
By A. K.
Gardner, M.
D.
Till very recent days the infallibility of the Pope,
the divine right of kings, and the arrogant lofty
claims of the physician were deemed equally indis-
pensable. But the 19th century sets at naught the
decisions of past ages and moves for a new trial, ap-
pealing against the decisions of the past.
Medicine, which was once the consideration of
everything proposed, accepted and recognized in
the whole domain of the curative art, by its own
narrowness and imbecility retreated from that lofty
position, and by expelling the propounders of al-
leged new truths, by flouting and ridiculing the
proposers of new principles — true indeed to a limited
extent, but wrong as general truths all-embracing
and revolutionary — has permitted these too san-
guine theorists not only to assert but to prove the
potency of their ideas, but — what was as incorrect
and as ill-judged as the action of their opponents —
to magnify and exaggerate the importance of their
various innovations and to attempt to create what
they denominated new "schools of medicine," not
recognizing, contradicting, even spurning the her-
editary lore of centuries.
The natural result of the arrogance on the part
of the former, and the pretension on the part
of the latter, has been to create an antagonism,
most bitter in its nature, founded upon error and
manifestly detrimental to the best interests of man-
kind.
The various schools, as represented by their ex-
treme men, the ultra Thompsonian, ultra Water-
Curer, ultra Homoeopathic, ultra old school physi-
cians, are all of them in the wrong ; they refuse to
see the light before them. As well might the repre-
sentative of Jupiter deny the light that comes from
Sirius, or one from the ring of Saturn question the
red light of the planet Mars.
The fact is that all of these bodies shine from the
reflected light of the sun, and the various "pathies"
and " isms " all have caught and radiate some
beams of a great central truth, but yet " one star
differeth from another star. "
The true man of real science to-day is one of
wide receptivity ; he recognizes a fact and is willing
to acknowledge it, no matter by whom propounded,
or whether it is or not satisfactorily explained.
And the people — " the common people heard
him gladly;" they say, "Who shall decide when
doctors disagree?" They say, " One thing I know,
whereas I was blind, now I see ; whereas I was sick,
now I am well. " They say, u Give me men, not prin-
ciples ; we can judge the men, but the depths of
medical lore is beyond our ken ! "
Fortunately, however, the science of medicine,
whose votaries separated at a forked road some
years back, and vaguely wandered in apparent
manifest divergence, have yet really both one
and all been making progress. " All roads lead
to Rome," Heaven is as near from one point as
another," and the honest seekers for truth, how di-
versely soever they wander, yet surely at the end
find themselves gathered together around the same
shrine.
Conservative allopathy has unwittingly been di-
vergent in her supposed uncompromising course.
The subtle powers of unsuspected gravitations, the
magnetic influence of even negative potentialities
have insensibly deflected her supposed unswerving
course. The unaccustomed atmosphere of a world
newly thinking, freshly investigating, and for the
first time deciding for itself by its own jury, has had
an unrecognized but powerful influence ; so that the
practitioner of half a century ago even would ac-
cuse his associates in "regular medicine" to-day
with being innovators and experimentalists.
Nor does Homoeopathy and the Water-Cure and
other new lights stand any more secure in the " an-
cient landmarks." Their names may indeed remain
unchanged, but the representatives, even the stan-
dard-bearers, are animated with modified ideas.
The truth is undeniable that in medicine as in all
strifes, the quarrel is strongest where the points of
difference are the slightest. The Christian, for ex-
ample, is far less truculent with the Mohammedan
or the Pagan than with some intermeddling affili-
ated sect. In like manner, the progressive men of
the various "schools" are now on converging lines
so closely approximating, that were not the separa-
tion kept up by the dividing party names, both
would now, in millennial quietude, lie down together
under the sheltering arms of the tree of knowledge
of good and evil, the science of medicine, and be
mutual, recognized by no other title than that of
practitioners of medicine, students of the ever widen-
ing science of life and death.
Whatever were the judgments of the past, to-day
the fact is undeniable that the exclusive follower of
any "ism " is a bigot, and his course shows a narrow-
ness inconsistent with the progress of the race. He
who would refuse to recognize the utility of gas,
steam, electricity, photography, might consistently
refuse to recognize the benefits derived from mod-
ern medical speculations and discoveries. Nor
would it be more absurd if one should refuse to
move except by steam, employ any other light than
gas, send a letter by mail, or adorn his walls with
the gems of the painter's art, than if he should re-
fuse to recognize the great truths of Hippocrates,
Galen, Pliny and myriads of their successors, whose
genius has saved the race from suffering, and res-
cued from premature death.
The bigots in medicine are either mercenary par-
tisans or weak-minded enthusiasts. Science needs
neither ; she asks for no quarrelsome defenders, but
appreciative students are attracted by her sublimi-
ties. Magna est Veritas et prevalebit.
But in the jar of contending forces the commu-
nity stand dubious. Which school is right ? Ig-
nqrantly the multitude array themselves under one
or the other's banners, 'and are perhaps even more
clamorous than their leaders. Neutrality is the
true position. In another place I have said, "How
to choose a family physician." The doubter here
will find additional light by re-perusing that article
in connection with this. The community are not
interested in the theoretic squabbles of their medical
advisers. The farmer does not ask his Yankee
whether he digs his potatoes with a hoe, or his
Irishman whether he exhumes them from their bed
with a shovel ; all he desires is to have his barrels
filled quickly.
The sensible man of family will think little of the
scientic dogmas of his physician, the truth or error
of which he cannot judge without a study requiring
time and capacity, which few can bestow upon the
subject. He can, however, judge the mental cali-
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bre of the men representing one or the other wing
of the profession, and can choose between them on
this basis. Thus judging he may perhaps find him-
self to agree with the Psalmist, who says, "The
liberal-minded man maketh glad."
CLINICAL NOTES FROM PRACTICE.
By W. N. Guernsey, M. D.
Case I. — In July, 1872, during the heated term,
when deaths from sunstroke in this city were num-
bered daily by the hundred, I was summoned to
see Mr. , at a neighboring town in Connec-
ticut. He was about thirty years old, of spare
habit, brunette, and generally enjoyed perfect
health. After some imprudence in eating, he was
attacked with cholera morbus. Under treatment
(allopathic) the severity of the attack was some-
what mitigated, but the nausea, vomiting and diar-
rhoea continued. Although carefully watched by
his physician, he became steadily worse, and on
the sixth day of the disease I was telegraphed for
to come in haste. I went, and found him confined
to his bed ; his face was sallow and sunken, and
his pulse soft and feeble. He complained of hav-
ing profuse watery diarrhoea, frequent vomiting,
and a feeling of extreme weakness. Nothing could
be retained upon the stomach, he said, and his thirst
was insatiable. His tongue was dry and of a reddish
brown color. That morning, according to his own
account, he had vomited every fifteen minutes. I
prescribed Merc. Sol., Arsen. Alb., and Veratr.
Alb., with the directions that the mercurius should be
alternated hourly with the veratrum until six doses
of it had been taken, and then arsenicum to be
alternated with the latter remedy. The patient
did not vomit again, and had only one diarrhceaic
movement after this plan of treatment was com-
menced. He convalesced rapidly, and in a few
days was out of doors and soon attended to busi-
ness.
Case II. — In August, 1872, I was called out of
town to see a case somewhat similar to the preced-
ing. The patient was an elderly gentleman of 60
years or more, and although ordinarily enjoying
fair health, he had been greatly prostrated from the
intense heat of the summer, and was suffering from
a severe attack of diarrhoea. It had already lasted
four or five days, and the patient was continually
growing worse, although during the entire timoi of
his illness he had been under the care of an allo-
pathic physician of some eminence and acknowl-
edged skill.
I found him very weak and confined to his bed.
The movements were profuse, very offensive, and
involuntarily passed at frequent intervals. His
tongue was thickly coated with a dingy white fur,
he had no appetite, and his pulse was very soft and
feeble. I prescribed Merc. Dulc, Arsen. Alb.,
and Veratr. Alb., with the directions that a small
powder of the mercurius should be immediately
taken, and to be repeated at intervals of two hours
until three doses had been given. Also, the latter
remedies to be taken alternately every half hour.
The diarrhoea was immediately checked, the ap-
petite returned quickly, and he made a speedy con-
valescence.
Case III.— Mr. O-
-, a middle-aged gentle-
man, suffered from a severe attack of cholera mor-
bus in July, 1 87 1.
My aid was solicited, and I found him in his bed
suffering with extreme pain in the stomach and ab-
domen. His face was pinched, the lips blue, and
the extremities were cold, and bathed in clammy
perspiration. The pulse was very weak, and could
be only faintly felt at the wrist. On examining the
abdomen, I found that it was covered with a mus-
tard cataplasm, and although it had remained on
so long that a blister was forming, yet he had felt
no unpleasant sensation from it, and had forgotten,
indeed, that it was there, so oblivious was he to
everything about him, as he lay writhing in agony.
I prescribed Merc. Dulc, and Colocynth, one pow-
der of the mercurius to be taken immediately, and
to be followed every fifteen minutes by the colo-
cynth. As an urgent case in the vicinity demand-
ed immediate attention, I left, promising to call
again on my return home. Half an hour afterwards
I did so, and found him sleeping quietly ; his pulse
was strong and full, and the skin was warm and
moist, and every evidence of his previous suffering
had disappeared. The next day the vomiting and
diarrhoea were checked, he was about the house, and
on the following one he attended to his business.
CASE IV. — In the summer, I was called out of
town in haste, to see a case of cholera infantum ;
I found a babe of about four months lying almost
lifeless, pale and cold as marble, in its mother's
arms. Its face was pinched, its eyes sunken, lips
bloodless, and ears transparent and waxy white.
Three minutes before, the mother, for a moment,
thought her child dead; but it gasped, and then
breathed faintly again, and I could faintly feel the
pulse beat at the wrist. The child had been sick
two days, and had never been strong, or displayed
much vitality.
The case seemed to be an almost hopeless one,
but as experience had taught me not to regard such
cases in children as necessarily beyond medical aid,
I prescribed Merc. Corrosiv. and Veratrum Alb.,
also three drops of camphor, to be put in a wine-
glass of water, and a few drops to be given at short
intervals. Brandy and water was directed to be
given, and, if possible, strong beef tea.
The following day, the father came and asked me
what remedy I could have given, that had produced
such a wonderful effect upon his child. The child
had improved rapidly after the first dose, and in a
couple of days was brought to the city, when it was
nearly well.
I have narrated these cases to illustrate the rapid
and effective action of homoeopathic remedies, as,
perchance, this paper may fall under the notice of
some allopathic physicians who still scoff at homoeo-
pathy, and who, either through ignorance or bigotry,
still think that with their school alone rests all the
knowledge of the laws of cure.
These were not exceptional, or remarkable cures;
such rapid results are attained every day, when the
remedies are administered according to the law of
"Similia. " Under that law, medicines act promptly
and effectively. What medicine culled from the
allopathic Materia Medica would have produced
such striking results, so quickly as Mercurius and
Colocynth effected in Case III ? Morphine, admin-
istered hypodermically even, would not have brought
such speedy relief and so gentle sleep. How could
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199
Opium have fanned the smouldering spark of vital
action into the vivid flame of active organic life, as
Merc. Corros. and Veratr. apparently did in Case
IV? And certainly, Nature, left unassisted, could
not have wrought such happy results. Homoeopathy
wears the laurels in the treatment of diarrhoea and
cholera infantum, as I have never seen such constant,
rapid cures under the most skillful of allopaths as are
made every day by the humblest of our practitioners.
A CASE OF PSEUDO-PREGNANCY.
By L. T. Warner, M. D.
In May, 1858, 1 was engaged by Mrs. N to at-
tend her in her approaching accouchment, which she
expected to occur about the first of October. She
was about forty years of age, had two living and
healthy children and now supposed herself to be in
the middle of her third pregnancy. In both of her
former pregnancies there had been a slight uterine
hemorrhage at about the fourth month. On this
occasion she was affected in the same manner.
In all respects the indications of pregnancy were
precisely the same as they had been on the two
previous occasions. Her menstruation was per-
fectly regular up ■ to the time of the supposed con-
ception. She had the usual morning sickness,
had experienced the sensation of quickening and
now felt the motion of the child distinctly. I did
not see her again until the last of September. I
found her then presenting the same indications of
good health that she did when I saw her four
months before, but considerably increased in size,
and having the appearance of a woman about to be
confined. The abdomen was quite prominent, the
breasts were very much enlarged and contained a
milky secretion. She informed me that she had been
perfectly well since I last saw her and that she had
constantly felt the motion of the child. The delay
which now took place in the occurrence of labor ex-
cited a slight suspicion in my mind that all was not
right ; but in view of the lady's experience in such
matters, her convictions as to her present condition
and her perfectly good health, I scarcely dared to
entertain a doubt, and did not think it worth while
to agitate a question which would be so soon set-
tled by time. At length, on the 19th of October,
she presented two of the ordinary indications of the
commencement of labor — a slight diarrhoea and a
subsidence of the abdominal tumor into the pelvis.
During that night she had a few slight pains accom-
panied by a "show." At 4 o'clock P. M., of the
next day, she commenced to have regular labor
pains. I arrived at her house between 7 and 8
o'clock in the evening and found the patient dressed
and walking about and everything appearing to be
as usual in such cases. The pains occurred at in-
tervals of 15 or 20 minutes. They were short in
duration, but quite sharp. As it did not appear to
me that the pains had been sufficiently severe to
make any very decided impression upon the os uteri,
I did not think it necessary to be in any haste about
making the usual disagreeable digital examination,
but decided to remain in the house all night so as
to be accessible if needed. In the morning the
nurse informed me that the pains had ceased entire-
ly at 12 o'clock. As a temporary cessation of pain
at this stage is not an unprecedented occurrence in
perfectly natural cases of labor, I, of course, was not
surprised. The pains commenced again the next day
about the same time that they did the day before,
gradually increasing in severity towards night, but
coming on at very irregular intervals. I visited her
in the evening, and having a presentiment that all
was not right, determined to make an examination.
I did so, and very soon discovered that she was not
only not about to be confined, but that she was not
pregnant ! I communicated this information to her
on the following morning. She was exceedingly
grieved and mortified at the revelation, and at the
same time disposed to be incredulous. Time, how-
ever, has proved the correctness of my opinion.
Up to the present time there has not been any return
'of the menses nor any uterine discharge. Her health
is and has been essentially good. The abdominal
prominence has gradually subsided, so that now
there remains only the embonpoint incidental to the
lady's age.
This case was probably one of purely ideal pseudo-
pregnancy coincident with the cessation of the men-
ses at the critical period of life. The lady had been
recently married to her second husband and they both
were exceedingly anxious to have a child. This
strong desire for offspring, the sudden cessation of the
menses, with the concomitant or consequent visceral
enlargement and probable tympanites, supplied all
the elements required by the imagination out of
which to establish a false sympathetic relation be-
tween all the organs concerned in and affected by
the function of reproduction. I have seen several
similar cases since and, from my intercourse with
members of the profession, am inclined to think
they are of more frequent occurrence than is gene-
rally supposed. When such a man as Sir James
Clarke can commit the very grave error of pro-
nouncing a case like this one of genuine pregnancy,
and when cases of genuine pregnancy can be mis-
taken for ascites and subjected to the operation of
paracentesis, as has been done by respectable mem-
bers of the profession, it behooves us to study more
carefully the phenomena of pseudo-pregnancy.
A RAPID AND COMPLETE CURE OF A NEU-
RALGIA OF THE UTERUS AFTER FRUIT-
LESS ALLOPATHIC TREATMENT.
By Dr. J. Kafka.
Translated from the German by William N. Guernsey, M. D.
I purposely select those cases for publication
where " the men of science" have exerted themselves
in vain to arrest the progression of a disease, and
yet under the homoeopathic law of cure, all the symp-
toms have been relieved, and recovery established.
Our opponents may therefore see that the physio-
logical pharmaco-dynamics, rightly understood and
skillfully administered, is no empty delusion ; and
also that the principles of the homoeopathic law of
cure are founded not in error and superstition, but
upon truth, and that by a proper and judicious
selection of the appropriate remedies, our results far
surpass theirs in certainty and rapidity.
Mrs. Schramek, a tailor's wife, 23 years old, pos-
sessing ordinarily a tolerably robust and well-devel-
oped form, is now greatly reduced by her present
illness. Twenty months since she was married, and
about three months ago she lost her only boy ; over-
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whelmed by this misfortune, she is changed greatly,
and since then has been afflicted with violent abdom-
inal pains, and been unable to obtain relief. This
good woman nursed her boy herself, and was happy
over his excellent condition ; suddenly, without any
known cause, he was attacked with diarrhoea, fol-
lowed by intestinal and brain cramps (the expres-
sion used by the patient ; probably colic, attended
with convulsions and insensibility), under which he
rapidly succumbed. Her grievous loss partly, the
disturbed lactation, and especially the depressing
condition of her mind, threw her on the sick bed.
Here she lay, tortured with the most agonizing
pains, and was treated allopathically, but so far
without the slightest relief, and consequently is on
the brink of despair. On the 21st of April, 1870,
my aid was solicited. I found the patient suffering
under the most agonizing pain, groaning and sob-
bing; she was continually invoking the "Holy
Family" to succor her, as is customary with her
class of people. Now, in incessant motion, she
doubled herself together — now stretched out the
legs, then threw herself upon the right side and then
upon the left, in desperation jumped up, immediate-
ly to throw herself back again upon the bed exhaust-
ed, and unable to procure any position to relieve
her distress.
The pain was localized principally in the hypo-
gastric region, and extended thence to the right hip,
and down the ischiatic nerve to the knee, and also
upwards to the right elbow. It was of a burning,
cutting, and pinching character, and produced
simultaneous reflex symptoms, as nausea, retching,
or vomiting, or a frequent desire to urination or def-
ecation, and a bearing down in the genital organs,
with the sensation as if something was being pressed
out there.
These attacks of pain occurred at indefinite in-
tervals, and lasted frequently uninterruptedly for
six or eight hours. During one of these periods
the whole abdomen, and especially the hypogastric
and right inguinal regions were extremely sen-
sitive to the touch ; there was no tympanites,
however, and percussion over every portion of the ab-
domen gave a resonant sound. The pains would
sometimes gradually, at other times suddenly, dis-
appear, and would remain away for two, four, or
six hours, when the patient could eat and sleep
somewhat. During an attack, however, no nour-
ishment can be taken, sleep is impossible, and the
patient, in great restlessness and agony, throws her-
self about as pictured above. Her pulse beats
rapidly, her cheeks are flushed, and skin dry, al-
though not feverish. As I was anxious to make an
exact diagnosis of the case, I visited her at a period
when she was entirely free from pain. I found that
at these intervals the abdominal walls were not sen-
sitive to pressure, and the sympathetic and reflex
symptoms had entirely subsided. The frequency
of the heart-beat and the pulse and the tempera-
ture of the body were nearly normal. Therefore,
there was no intimation of any peritonitis or other
inflammatory process present. At the same time I
made a digital examination of the uterus, and
found the os lengthened, proboscis-like, the body
somewhat enlarged and hard, and the vagina moist
and cool.
The thirst was not increased either in the parox-
ysm or out of it, the appetite disappeared entirely
during an attack, but at other times soup and milk
were eaten with considerable relish. The urine
was, during the pain, pale and copious, and from
the constant desire to urination, was passed at fre-
quent intervals ; there was much constipation, and
although during the attack there was a constant in-
clination to defecation, no movement ever occur-
red, and it was only produced by lavements.
The patient could only sleep at the intervals when
free from pain ; she felt very weak, and was, owing
to the long duration of her illness, somewhat
emaciated, and although she looked worn by her
great suffering, her appearance was not of the
worse.
It may be clearly seen from this history, which
has been drawn true to nature, that we have no in-
flammatory process before us here, but that there ^ is
present a severe form of neuralgia accompanied
with a slight infarction of the uterus. The latter is
probably the result of a faulty involution of the
womb after her last confinement ; and the uterine
neuralgia a sequel of the depressed condition of her
nervous system resulting from the grief for the loss
of her loved boy, and therefore has attained such a
severe form. To relieve this condition, mixtures of
almond or castor oil combined with aq. laurocera-
sus or with opium or morphine, flowers of zinc and
the valerianate of zinc, had been prescribed on the
part of the allopaths. Various anodyne salves and
embrocations had been made use of, and towards
the last, morphine injections* had been tried, as also
aromatic and tepid water baths, but with purely
negative results.
According to my own convictions, the main ques-
tion here was to mitigate or relieve the severe parox-
ysms of pain, and then afterwards take into
consideration the infarction of the uterus. As the
pain attained the degree of insupportableness, and
as also the abdominal walls were so hypersensitive
during the attack, I prescribed Belladonna 3, in so-
lution, with the directions two tea-spoonfuls to be
taken every two hours. Also, I directed her during
an attack to remain as quiet as possible, not to moan
any, as it only aggravated her disease, and not to
throw herself about, as the pains were more easily
subdued when in a state of repose. And, indeed,
within two days a marked diminution of the severity
of the pains was obtained with this remedy ; yet,
the attacks did not entirely disappear. As I saw
after four days further trial that the paroxysms were
diminished in severity but not in duration, I pre-
scribed Atropine Sulph. 3, with the view of making a
greater impression upon the disease, as in my expe-
rience this remedy alleviates spasms of pain more
forcibly and rapidly than Belladonna. The result
justified my expectations in so far that after six
days' administration of the Atropine the pain became
much more tolerable ; yet the attacks were not dis-
continued, and they were of as long duration as for-
merly. In the last one the pain was quite severe
again, and it was evident that the remedy must be
changed if a favorable result was to be obtained.
I examined with renewed care all the subjective
and objective symptoms again, and found as char-
acteristic, not the pain only, but also its severity
and its reflex action upon the neighboring organs,
viz : the bladder, the rectum and the uterine plexus ;
and from these symptoms as a stand-point, I select-
ed Cocculus 3. This was May 4th, and it was to be
given in solution, and a dessert-spoonful to be
I taken every two hours. When I say in my treat-
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201
ment that a properly selected homoeopathic remedy
which answers to the totality of the symptoms acts
swiftly, I base my opinion upon a great number of
observations and practical experience, gathered di-
rectly by the sick bed ; and the truthfulness of my
assertion was most brilliantly verified in this obsti-
nate case. Immediately on the second day of the
use of this remedy, a perceptible improvement in the
condition of the patient could be observed. The
pain was considerably less severe, and the parox-
ysms occurred more seldom. On the 8th of May,
the patient was free from pain during the whole day,
and only in the evening was there a slight monition
of it, which disappeared in about twenty minutes.
From this day all the paroxysms of pain entirely
subsided. With the rapidly progressing improve-
ment in the condition of the patient, and under the
continued administration of Cocculus (which was
gradually reduced to three, two and one dose each
day), there was no longer any trace of vesical or rec-
tal tenesmus, and no further sensation of bearing
down in the genital organs. The abdomen tol-
erated firm pressure, the bowels, the urinary organs,
sleep and appetite gradually regulated themselves —
only the uterus remained infarcted, which was
proved by an internal examination.
That this important factor of the disease in ques-
tion might be mollified, I ordered luke-warm baths
of 15-30 minutes' duration three times a week,, and
prescribed Iod. 2, for internal use, in the powdered
form, and a dose to be taken thrice, daily. After
eight days I found the swelling of the uterus much
less marked, and the proboscis-shaped prolongation
of the os smaller and perceptibly softer. Still eight
days more and I could have dismissed the patient
from treatment, as the infarction was rapidly disap-
pearing, and the patient otherwise in a normal con-
dition. I recommended that she should be an out
patient, so that I might observe the further progress
of the recovery. I ordered the warm baths to be
taken only twice a week, and of thirty minutes'
duration each, and the Iodine to be continued
twice, and later on, once daily.
By the middle of June, the patient was dismissed
as entirely recovered. She had regained her good
looks, and in October of the same year she an-
nounced to me with great glee that she was again
enciente.
Cocculus is a remedy which many of our allo-
pathic physicians do not even know by name, and
with whom it has fallen into disuse. Pikrotoxin is,
according to Orfila's universal toxicology, its chief
ingredient. This remedy was proved physiologi-
cally by Hahnemann and his associates, whereby its
action upon the system and the various organs was
clearly demonstrated.
To the indications for the administration of this
remedy, as extreme painfulness of the affected por-
tion to the touch, aggravation of the disease in repose,
relief by motion of the body, etc., I may add, as
among those most marked, the reflex symptoms, which
involve the whole muscular system, the feeling of dis-
tress in the stomach, and nausea, bearing down sen-
sations in the uterus, rectal and vesical tenesmus,
and sometimes in the inguinal rings a feeling as if
a rupture was about to occur. I selected Belladonna
and Atropine at first, because an extended experi-
ence by the bedside speaks well of these remedies,
as they have a quieting action upon those symptoms
which take their departure from the uterus, and
soothe and relieve the severest forms of pain, and
the most marked hyperesthesia of sensitive organs.
As has often been demonstrated, these general indi-
cations proved to be insufficient. I was forced to
consider the special symptoms, and these particu-
larly were the clue to my success in this case,
which had been treated allopathically without the
slightest result having been produced. The advo-
cates of the individualization and specializing theory
may see from this that I believe in the exact and
tolerably well restricted action of a remedy, and by
no means express myself in behalf of the generali-
zation theory. But I may ask, what can we accom-
plish at the bedside without having a general knowl-
edge of the action of our medicines ? Who among
us, even if he be the oldest and busiest practitioner,
can pride himself in having such a gigantic memo-
ry that he knows the homoeopathic materia medica
in all its minutest particulars ?
Even Von Bcenninghausen, one of the most pro-
foundly versed of his time in the knowledge of the
homcepathic remedies, found it often necessary to
read his physiological pharmaco-dynamics, that he
might not overlook all the special indications.
Every practitioner must possess a certain degree of
knowledge of the general action of the homoeopath-
ic remedies, if he expects to be properly armed and .
equipped that he may obtain good results by the
bedside. It often happens, however,/ that this
general knowledge does not suffice ; that, for ex-
ample, instead of Aconite, Mercur., Hepar or Bryo-
nia is required ; instead of Nux Vom. , Natrum Mur. ,
or Magnesia Muriat, or Sulphur, and in place of
Bryon. , Dulcamara or Pulsatilla or Rhododendron.
I am therefore of the opinion that in every case we
must first make use of our knowledge of the gene-
ral action of a remedy : the knowledge of its espec-
ial indications is to be derived partly from the
practical deduction from clinical observation and ex-
perience, and partly to be found in our homoeopathic
materia, the careful study of which may here be
most urgently recommended to every assiduous ho-
moeopathic physician.
BROOKLYN HOMEOPATHIC HOSPITAL SUR-
GICAL CLINIC.
By A. Varona, M. D.
Case I. — R. A. K., aged 32, entered the surgical
ward under my care, on the first day of April, suf-
fering from a disease which, though having all the
appearances of an encephaloid cancer of the testi-
cle, proved to be (from the very interesting history
of the case given by the attending physician, Dr.
Gorton) a fungoid syphilitic sarcocele. The testi-
cle being completely desintegrated, a fungus one-
third the size of the whole tumor (which was as
large as a turkey's egg) protruding through its base,
castration was decided upon.
I operated on the second day of April in the fol-
lowing manner :
The patient having been placed under the influ-
ence of chloroformed ether, and the parts duly
shaved, I made two elliptical incisions, including the
fungus and a small portion of the scrotum. I enu-
cleated the testicle, carried the dissection up to the
spermatic sheath, transfixed this with a whip-cord,
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gave it to an assistant, directing him to drag it down-
wards, divided the spermatic cord half an inch be-
low the transfixed point, tied it en masse (very
tightly) also below the whip-cord, and allowed it to
go back to its place, leaving the whip-cord in situy
holding by its means all possible secondary hemor-
rhages under control. There being no flow of
blood from the scrotum, the wound was closed by
sutures, leaving an open space at the base for the
exit of suppuration.
With the reaction a little bleeding occurred, but
cold water checked it effectively, and the patient
steadily improved without the slightest pain or in-
convenience of any kind.
On the fifth day I removed the whip-cord; on
the ninth the ligature came off, and on the fifteenth
(April 17th) the patient left the hospital completely
cured of this most troublesome disease.
In this case the English method of ligating the
cord en masse gave perfect satisfaction, and I
operated in this manner, as I have on three previ-
ous occasions, because I am convinced that the
fears entertained by some American surgeons (Ham-
ilton's Practice of Surgery, page 871) of its produc-
ing severe after-pains, are groundless, if the liga-
ture be applied tightly enough, not only to oblite-
rate the spermatic, the deferential and the cremas-
ter arteries, but with the additional force necessary
to completely crush the spermatic, genito-crural and
ilio-scrotal nerves.
ON THE VITALITY OF HIGH ATTENUATIONS.
By W. Freeman, M. D.
About twenty years ago I got from old Mr.
Lentz, of Philadelphia — an honest enthusiast in Ho-
moeopathic attenuations — some of his high poten-
cies, which I used for several years with varying
success, and after having used up some of the most
important remedies, the rest were gradually laid
aside and superseded by other attenuations. No
particular care was taken of them, and they were
tumbled about in a drawer with mother tinctures,
triturations, odds and ends, so that I thought there
could be but little if any virtue left in them.
Some time since, I had a patient who was exceed-
ingly troubled with constipation. I had given him
Nux — Sul. — Hyd. — Collinsonia, &c, without any
lasting effect, and, by way of experiment, I thought
I would try some of the old remedies of Lentz'. I
dissolved some pellets of Plumb. 409, in a few drops
of water in a vial, filled it with alcohol, giving it a
good succussion, and gave it to my patient with in-
structions to take fiVe drops night and morning un-
til his bowels became regular, then stop, and take
again if necessary.
Some time after that I saw him. He said that
was the only medicine I had given him that had
done him any good.
That was two years ago. He has had the vial re-
newed once since and it has been for him a sure
relief.
I have given that preparation of plumb, in several
cases since of chronic constipation, and nine times
out of ten with perfect success.
I must say I have been astonished at the action of
that old preparation of plumb, which, after being
tumbled about with all sorts of strong remedies, ex-
hibited as much power and vitality as when I first re-
ceived it.
ALBRECHT VON GRAEFE.
A RECENT article by the Rev. Wm. H. Milburn,
for so many years known as the eloquent "blind
preacher," recounting his impression of one of the
most remarkable men the medical world has ever
produced, is so full of beauty, and sketches the great
oculist in such just and truthful colors, that we can-
not refrain from transferring portions of it to our
pages. Mr. Milburn, when but five years old, re-
ceived an unlucky blow from the hand of a play-
mate, which inflicted a severe wound in his left eye.
He says, in speaking of it, " Had the incident occur-
red a hundred miles from a doctor, and my mother
applied a wet bandage to my eye, I might have
been saved more than forty years of twilight deep-
ening down into utter night." When nearly two-
thirds of his life had passed, measuring human life
by the usual standard, attracted by the world-wide
fame of the great German professor, he placed him-
self under his medical care, and this is his impres-
sion of that wonderful man :
" It would be hard to convey to those who never
knew him, an adequate and yet credible notion of
this man's tireless and almost superhuman labors.
Although slight of build, narrow-chested, often
gasping for breath, he seemed to defy fatigue, and
set at naught the limitations of work which hedge
most men's activity. He was usually up by seven,
passed an hour or two in study, then read and
answered his letters while taking his coffee. Nine
was the hour for his lecture at the Klinik, where
students and physicians from all parts of the globe
were gathered. Fleet as his horses were, he was
usually behind time. All impatience, however, was
banished, as with a quick step he entered, breath-
less but smiling, and said, ' I was to be punctual
to-day; well, that will be for to-morrow.' A more
beautiful man's face than his has hardly been seen
in modern times. Who that has looked upon it
can forget the high, broad brow of the noble head,
the dark blue eyes, and the exquisite lips, where sat
such mingled beauty and power ? It seemed, indeed,
only as a lovely transparency through which the
light of a still more lovely soul was shining. His
action was quick and decided, yet graceful, his
voice very pleasant to the ear, his speech easy and
affluent. His manner had the simplicity and spor-
tiveness of a child's, and yet you felt the dignity and
authority of a master. Wholly unaffected, and even
unconscious, in all he said and did, he yet breathed
around you the atmosphere of supreme genius. It
was strange to watch the love and reverence which
attended his steps. The hour's lecture over, during
which he had held the great throng spell-bound and
even breathless by his eloquence, the death-like
stillness broken now and then by irrepressible
applause, he proceeded on his daily visit through
the wards of his hospital. Day by day have I
noticed the flurried manner of nurses and atten-
dants, their eagerness tempered by a kind of devout
worship, the hush of expectation which waited the
master's coming — and now you hear his fleet, light
steps, which keep his aids upon a run. He is in
your room, where darkness and pain vanish at his
cheering salutation. The bandages are removed in
a trice. The examination is made with rigid fidel-
ity— there is no haste here ; the bandages are re-
placed, and away he goes, with loving words, which
leave sunshine behind him.
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203
"To this Klinik all who wished his care and ser-
vice, no matter what their rank or fortune, were
obliged to come and take a bed. Half the patients,
at least, were so poor that they could not pay the
master's fee, and were even unable to defray the
charge of their living : this came out of his generous
bounty, and they received the same attention as the
richest clients. After the visit to every patient, the
operations began. Each case had been thoroughly
examined and studied by one of his aids, and then
by the master himself; so that he knew just what to
do, and how to do it. Some days there were as many
as sixty persons to be operated upon. Each patient
was numbered, and the line was marshaled by the
assistants and nurses. One by one they quickly took
their places on the table ; while, seated in his chair,
his instruments at hand, the master proceeded
promptly, but gently, to inflict the pain which was
to give life-long relief — scores, sometimes hundreds,
of students standing by to witness the dextrous man-
ipulation. Scientific method and military system
reigned throughout, and yet no exact programme
of details bound this man in chains ; he kept him-
self free to meet whatever exigency might arise hour
by hour.
"The operations were usually ended by 5 P. M.,
the hour at which he professed to dine ; but his
swift horses rarely brought him to his house much
before six. At dinner his buoyant spirits would
break forth in charming talk, and all kinds of frolic
and fun. Long before seven o'clock his anterooms
were crowded by patients from all quarters of the
earth, waiting for their preliminary examination.
These were admitted one by one, each in his turn,
to the cabinet, where the master patiently and care-
fully explored each diseased organ, and kindly, yet
honestly, told the sufferer what he had to hope or
fear. Thus was he occupied until ten or eleven at
night, when the carriage was in waiting to bear him
once more swiftly to the Klinik, where he made a
minute examination of every patient operated on
that day and the day before. In my lonely vigils
I used to hear his carriage bearing him away at be-
tween one and two in the morning. In addition to
this daily round, how he found time for his private
studies, and the composition of his voluminous
works, is more than I can tell ; but time he did find
to accomplish, as student and author, what would
have made immortality for any other man, and at
the same time to achieve such practical feats of
skill, energy, and success as would be the full mea-
sure for a prodigy. Such was his life at Berlin for
ten months a year, from 1850 to 1870, save when
interfered with by sickness. On the 1st of August
in each year he set out for Switzerland, to refresh
himself among the mountains, which were to him as
friends and consolers, in whose society he gained
new life and inspiration. On the 1st of September
he went to Paris, and by the 1st or 2d of October
was at home again, exact as the sun-dial. Two
months which were meant for recreation could not
be released from the importunate hand of suffering.
The afflicted from all climes followed to his moun-
tain home, and thronged his temporary salons
in the French capital. His generous heart could
not resist the appeals of the unfortunate ; and he
held that a holiday in which he was obliged to work
only eight or ten hours.
" In 1862 he was married to the Countess Kneuth,
a Danish lady of great beauty of person and charm
of manner, but still greater beauty and sweetness of
character, who thenceforth devoted her life to his
comfort and happiness. Such were the depth and
strength of her affection for her idolized husband,
who breathed his last in her arms, that she survived
him but a few months, dying, it is supposed, of a
broken heart. There is a story told, I know not
with what correctness, that their acquaintance began
in his Klinik, where she was a patient. After ex-
amining her eyes, he told her that the operation
might cost her her beauty. She mildly but firmly
requested him to proceed, adding that the beauty
was of little consequence.
" Such was his estimate of the value of time, and
his delicate sense of responsibility to the crowd of
patients who daily waited upon his ministrations,
that he could hardly be induced to attend any one,
no matter how high the rank, save in his own hos-
pital. The Czarina of Russia, then at Nice, sent an
imperial summons for him to wait upon her there.
He declined to go, on the ground of injustice to his
patients. The Czar was obliged to seek the inter-
cession of King William, the son of Von Graefe's
godfather. At his urgent solicitation the professor
consented to make the journey, traveling by express.
Entering the imperial presence, he made a brief ex-
amination of the Czarina's eyes, assured her that
the course pursued by her own physician was quite
correct, and without an hour's halt set out for Berlin.
The Queen-Dowager of Prussia, who is said to have
been a peculiar person, insisted that Von Graefe
should come to Potsdam. He declined, on the
ground that he could not spare the time, and sug-
gested that she should come to the Klinik. This
she absolutely refused to do, and King William was
obliged to mediate once more. At his request, the
professor promised to give the Queen one hour. A
royal train was in waiting at the station, which bore
him and his attendants with lightning speed to
Potsdam, where carriages were ready to carry them
to the palace. A lady in waiting informed the pro-
fessor that her majesty was not yet up, but would
receive him in an hour. Pulling out his watch, he
answered, ' In forty minutes from this time I will
be at my Klinik. ' The Queen made her appearance
in five minutes ; the operation was performed ; he
returned to his hospital, and had ten minutes to
spare. Thus must royalty sometimes bow to genius.
Covetous of time, he was in all things else bountiful
as the day. Although the revenue drawn from his
private clientage was princely, notwithstanding the
price for operations and treatment was fixed and
very moderate, it was absorbed by his benefactions
to those sufferers who were unable to pay, and to
whom he gave bed and board, as well as light.
While simple in his tastes, and inexpensive in his
personal habits, so munificent were his charities
that not only was his professional income spent, but
his private fortune trenched upon. Affliction and
poverty never appealed to him in vain ; and even
time, which he hoarded as a miser hoards gold, he
used as a steward for mankind.
"Stricken down by disease, for days he hovered
on the brink of death. When my own health became
better I went to take my leave of him. It was in
the evening, at his own house. I found him wasted
to a shadow, his hand feverish and almost transpa-
rent, his breathing short and labored, and appear-
ing so far exhausted that he could not last twenty-
four hours longer. Very sweet and full of grace it
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was to sit once more in the radiant atmosphere of
that man's presence, and hear the high soul, almost
disembodied, use the words of our mortal speech.
On the morrow he was to leave for Italy, I for Paris.
I felt as if letting go the hand of one passing behind
the veil of eternity. Softly we said good-by, and
never met again. Such was the man's wonderful
hold on life, and the reinforcing power of his will,
that in the balmy air of Italy he gained a new lease
of existence, and came back to Berlin with the birds
and the fine weather. For another year, and more,
the shrunken skeleton daily walked the wards of his
Klinik, and the day before his death he performed
ten operations. In the last months of his life he
composed and published a magnificent and exhaust-
ive treatise on glaucoma, that fearful disease of the
eye which he was the first to explore and cure.
This work was the song of the swan. Writing to
Warlmont, at Brussels, in January of this year, he
said, referring to a literary task, 'Try to send me
proofs easy to revise, because I feel myself sick;
and when I work more than ten hours a day I feel
it deeply.' A very little while before his death,
writing to Donders, at Utrecht, he said, 'I am
growing worse. Let us not speak of my health
now; every hour that begins seems to be my last.'
"Notwithstanding his languishing, nay, dying
condition, the sublime dedication of himself to the re-
lief of human suffering and the energy of his inflexi-
ble will held him up to the use of the knife and the
pen until the very last. Possessed of an indomit-
able and devouring zeal, he ended by being devour-
ed himself. The end came on the 20th of July,
1870. 'Draw the curtains,' he exclaimed at the
supreme moment, * and let me look upon the sun
once more, ' and died with the calm of the sage and
the peace of the Christian. Brief as had been his
career, the measure of his greatness and his fame
was full. Most of the medical and scientific socie-
ties of the world had chosen him an honorary mem-
ber ; and many sovereigns had conferred upon him
their decorations, among others the Czar of Russia,
the 'Grand Cordon of the order of St. Stanislaus ;'
the men of his own profession throughout the world
held him as their prince or master. He advanced
the knowledge of the eye and of its proper treat-
ment under the manifold grevious ills to which it is
subject, from the obscurity in which it had rested
from the foundation of the world to the light and
certainty of a comprehensive science, while the
blessings of tens of thousands who were ready to
perish were after all his highest meed of honor.
When one reflects that Albrecht von Graefe passed
from earth at a little more than forty-two years of
age, and that his " scientific and practical career
lasted scarcely twenty years, his manifold and
mighty works create an astonishment which beg-
gars words. When Graefe breathed his last, Eu-
rope trembled under the tread of embattled hosts.
Father William was going forth at the head of his
armies to engage in the death-grapple with his
French adversary. The flower of Germany was
with him, and many a man on either side of the
fray showed himself a hero, but not one of them ex-
hibited higher qualities, or deserves a more lasting
and illustrious commemoration, than he who was
looking on the sun for the last time when the armed
strife began. Half the population of Berlin escorted
his coffin to the tomb, and buried it under roses and
palms. The poor wept because their benefactor
was gone, and the great felt in grief that the bright-
est and most beneficent light of modern science was
quenched."
The Possible Existence of Liquid Solar
Envelope. — At the recent meeting of the Ameri-
can Science Association in Portland, Prof. Charles
A. Young, whose name is so well known in
spectroscopical science, read a paper which excited
great general interest, on the possible existence of
liquid solar envelope. It is the opinion of astrono-
mers of the present day that the substance of the
sun is largely metallic. But it is also shown that
the specific gravity of the sun is only one and a
quarter, water being taken as one. The only mode
of harmonizing these two facts is by the supposition
that the metallic matter of the sun chiefly exists in
a gaseous condition. There are also many corrobo-
rative indications that such is the case. The exist-
ence of the well-known sun-spots, which appear and
disappear so suddenly, and also the frequent vol-
cano-like eruptions which take place on so gigantic a
scale, rising sometimes to a height of 200,000 miles,
leave no doubt concerning the existence not only of
superficial disturbances, but also others of still
vaster violence. As these vast masses of gas are
projected from the central to the exterior portions
of the sun, they must suffer great diminutions of
temperature. This refrigeration probably extends
to liquefaction, so that we may suppose these gas-
eous masses condensing precisely as watery vapor
condenses when it rises into the colder regions of
the upper air. We would then have the phenome-
non of a solar metallic rain. The descent of this
rain would be checked as it approached the centre
of the sun, and would then accumulate as a liquid
layer or envelope, receiving fresh accessions from
above, and wasting by rapid evaporation on the
inner and more heated surface. Thus large quan-
tities of vapor would be constantly forming in the
interior of this liquid shell, and would escape from
time to time explosively, when the tension became
sufficient to rupture the envelope. Indeed, the sun
is probably only a gigantic bubble, bursting and re-
forming itself continually. Prof. Young is inclined
to think it probable that the condensation of the
ejected gaseous matter may possibly extend beyond
liquefaction — that it may even be reduced to the
solid condition, and that the sun may have within
its chromosphere and its photosphere, its storms of
metallic snow.
Chloral as an Application in Fetid Ulcer.
— MM. Dujardin-Beaumetz, at a recent meeting
of the Paris Medical Hospital Society, communi-
cated his experience of the use of Chloral Hydrate
in the treatment of ulcers. He narrates several ex-
periments to show that fermentative substances,
such as albumen, muscle, urine, milk, &c, may
have fermentation entirely prevented by placing
them in a solution of chloral, Tom being sufficient to
arrest the lactic fermentation of milk. He has ap-
plied it to ulcers, gangrenous wounds and wounds
of a bad character of the strength of -fa to j^w with
very excellent results. As it prevents decomposi-
tion, it may render great service in affections of the
urinary organs.
The Chair of Physiology at Edinburgh
is likely to be soon vacant by the resignation of Prof.
Hughes Bennett, from ill health.
The Medical Union.
205
The Medical Union
A MONTHLY JOURNAL
Of Medicine, Surgery, and the Collateral Sciences.
Editors :
EGBERT GUERNSEY, M,D. CHARLES E. BLUMENTHAL, M.D.LL.D.
JOHN C. MINOR, M.D. ALBERT E. SUMNER, M.D.
H. M. PAINE, M.D.
Published on the First of each Month, by
C. T. HURLBURT, 898 Broadway, New York.
NEW YORK, SEPTEMBER, 1873.
" A regular medical education furnishes the only presumptive
evidence of professional abilities and acquirements, and ought to be
the only acknowledged right of an individual to the exercise and
honors of his profession." Code of Medical Ethics, Amer. Med.
Ass., Art. iv, Sec. i.
MEDICAL EDUCATION.
In our opinion, a great deal of the talk of elevat-
ing the standard of medical education which is now
so popular in all schools is, in political language,
" buncomb." Talk is easy ; performance is a more
difficult matter. Every college professes to hold
out some superior advantages either in the ability of
its teachers, the thoroughness and completeness of
its course of studies, or in the variety and extent of
its clinical advantages. That institution which
furnishes the best practical teaching, which is the
most thorough in its course of instruction and best
fits the student for the arduous duties of his profes-
sion, and which most fully meets the wants of the
times, will sooner or later, no matter what the
school, homoeopathic or allopathic, take the highest
rank in the scientific world and carry off the palm
of success. It is perfectly idle to talk about the duty
of supporting one school in preference to an-
other. This question resolves itself into a matter
of business, and as a matter of self-interest students
sooner or later will flock to those places where they
can get the best clinical advantages and the most
complete and thorough instruction in that profes-
sion from which they hope not only to gain their
daily bread, but wealth and fame. If you wish to
attract students to your colleges, do so, not by pom-
pous announcements and promises, made only to
be broken ; not by urging upon the profession the
duty of patronizing schools of their own faith, but
by making them so complete, so thorough, that your
students, in point of medical knowledge, will stand
foremost in that profession which is ever advancing.
We are reaching a time in our profession when
even licensed stupidity will be treated with the con-
tempt it deserves, and when a man, to insure perma-
nent success, must possess something more than a
mere smattering of knowledge gained from a few
months' or years' careless study. When he steps
out upon the great battle-ground he will find many
a fine-spun theory will be swept away before the
sturdy blows of hard facts. He must not only pos-
sess practical knowledge, but know how to apply it
with that coolness and precision which the exigen-
cies of the case may require.
The people do not care for theories, they want
facts and results, and will select as their physician
the man they deem the most skillful in relieving
pain and arresting the progress of disease, no mat-
ter what his medical or theological faith. The ad-
vancements of science are such that the laggard or
drone who cannot, or will not, keep pace with the
onward march soon finds himself in the background.
It is with the physician a matter of self-interest, a
matter of position, and wealth, and comfort to keep
up with the tide, to stand ever in the front rank of his
profession, and avail himself freely of the rich stores
of facts gathered during the ages by careful workers
in every department of medical science from every
part of the world.
Legislate as much as you choose, pass as many
laws as you please to elevate the standard of medical
education, make, if you like, the approach to a de-
gree through a long lane of Greek and Latin, and
German roots, dry and sapless, and musty with
age, breathing the decay of the vault, and what have
you gained? This question of medical education,
like every other business question, will regulate itself.
The student will be forced into higher scientific at-
tainments, into more practical studies by the de-
mands of the age. The tremendous strides which
are every year being made in every department of
the great world of science force him, if he would
hold up his head among his brethren, to sweep on
with the tide. Only let him get his instruction where
and in what way he can secure it the best, with the
assurance that the highest educational authority in
the State will testify, under the broad seal of the
State, to his educational qualifications if he can pass
an examination before its chosen officers, and you
will find him ready and willing to do his part.
Medical colleges in this country are simply associa-
tions of physicians for the purpose of teaching, the
faculties self-constituted, or brought together by a
little wire-pulling and skillful manipulation. Some
of the members of the faculty may be men of
thorough scientific attainment and great tact and
skill in grouping together facts and impressing them
upon the minds of others, while others in the same
faculty may be much better qualified to play the
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The Medical Union.
part of clown in some traveling circus, or be so dull
and unpractical as not to be able, from their own
merits, to draw a dozen students; and yet they all
form a part of the same faculty and all must be lis-
tened to with respectful attention, because they are
all to sit in judgment upon the students at last.
The important question is now being discussed in
many a physician's office and in many a home — a
question all important to the student and in which
the preceptor feels a grave responsibility — with what
institution shall the student connect himself the com-
ing winter, where he will receive the most thorough
instruction and be best fitted for the duties of a
profession which looms up so grandly before him
and to which his whole future life is to be devoted.
And so, different colleges are discussed and their
faculties and machinery of instruction carefully an-
alyzed. In each of three or four colleges in a single
city there may be one or two men of such marked
ability that the student feels it all-important to
enjoy their instructions, while the others in the
same institution are of inferior ability. And so he
selects the one, perhaps, in which there is the least
dead wood, and goes on with his studies, mourning
that he is debarred from instruction so much de-
sired, by the foolish and unwise legislative require-
ments that he must take all the tickets and attend
a full course of lectures in the institution in which
he receives his degree.
We are rejoiced that by a "recent act of the legis-
lature this great obstacle to medical progress is re-
moved, and now the student can pick out his own
teachers, availing himself of the ripest experience in
the profession and obtain his degree, if he desires one,
from the highest educational authority in the State.
He. is not now confined to the lecture-rooms of a
single college or the instruction of a single office.
Colleges will find if they wish to fill their lecture
rooms, every chair must be filled with distinguished
ability, and the machinery of teaching made as com-
plete as possible. In opening the door to a broader
and more liberal instruction, there is danger that much
of the good which a State Board of Examiners might
produce, if rightly constituted, maybe prevented by
the construction of the Board itself. The Board, to
have any weight, should be made up from the
ablest men in the various' departments of our pro-
fession ; otherwise, it becomes the broadest farce and
sinks below the level of contempt. If the student
is to encounter mediocrity he will pefer meeting it
in college faculties to encountering it allied with
stupidity in State Boards. Properly constituted, the
awards of the Board would be a prize to stimulate
ambition. We have said self-interest will prompt a
man to obtain as thorough a knowledge of his pro-
fession as possible. Does he not, however, some-
times forget in his eager striving after fame and
wealth that his profession is not a mere trade, but
something high and holy, which takes hold of the
higher and nobler qualities of his nature, the very
spirit of which should cause him to shun a mean act
or a lying and slanderous word, as he would the
breath of the pestilence. The true physician is
above the selfish and miserable tricks of trade, and
cherishes the honor, the integrity, the intelligence
of his profession as he would the purity of his soul.
ELEGANT EXTRACTS.
From a recent number of a New- York medical
journal, we copy the following elegant and eloquent
extracts :
" Especially does it delight us to take up an essay
by one who rejoices in the vocation and titular dignity
of an M. D., and who rears his head above the daily
harassments of the one, and the class prejudices of
the other, and gazes with undimmed vision into the
empyrean of the prima philosophia of classic writers
too much contemptuously spurned in this age as
misty metaphysics."
Eloquent and Addisonian as is the above passage,
it is only the prelude to what follows. " The ten-
dency of the profession to speculate over the won-
ders of the animal economy, and to develop jejune
theories out of imperfect inductions, or cardinal ig-
norance of its intricate details, is a part of the history
of medicine from the mythic teachings of ^Escula-
pias to the present hour. Hoffman, in the seven-
teenth century, was not wholly able to break the
shackles of the Cartesian philosophy. Haller caught
the spirit of Newton's resolution of planetary motion
into that of centripetal and centrifugal force, and
propounded the vis insita and the vis nervosa that
he might stand out a dualist. At the very time we
write, Maudsley's discussions on mind and body sep-
arate him from the dualistic school, make intellect
a function of the brain, and posit his system into
monism."
Precisely so. The statement is undeniable. Strange
as it may seem, this is undoubtedly the tendency of
the medical profession, and we cannot deny, now
the fact is so clearly stated, that Maudsley's train of
reasoning does separate him from the dualistic
school, and posit his system into mo?tis?n.
Transfusion. — Lately, at the Children's Hos-
pital, Great Qrmond Street, Mr. Warrington
Harvard resorted to transfusion, in the case of a
child who was moribund from purpuric hemorrhage.
Eleven ounces of blood, defibrinated with an "egg
wisp," and strained through a hair seive, were
introduced; the effect being to revive the child, who,
for a time, became conscious, complaining of head-
ache. After the lapse of a few hours, however, she
again became pulseless, and sank. The post-mortem
examination revealed no evidence of embolism.
The Medical Union.
207
{Transactions of Societies.
SEMI-ANNUAL MEETING OF THE STATE HO-
MEOPATHIC MEDICAL SOCIETY
At Brooklyn, September 9.
The morning session of the Semi-annual Con-
vention of the New York State Homoeopathic Medi-
cal Society was held in the Common Council Cham-
ber. Delegations were present from various parts
of the State, while Brooklyn, of course, was well
represented in the Convention, not only members
of the society being in attendance, but many friends
of the principles enunciated by the great Hahne-
mann. Several ladies were noticed among the
number.
Dr. E. D. Jones, the President of the society,
called the Convention to order.
MAYOR POWELL'S WELCOME.
His Honor Mayor Powell, shortly after entered
the room and tendered words of welcome to the
gathered representatives of Homoeopathy. He was
introduced by the President. Mayor Powell said that
he felt a pleasure in welcoming them to the City of
Brooklyn. Their profession was a noble and honor-
able one, and he was glad to see that their efforts
had been in a large degree successful. He con-
gratulated the society upon its progress, and after
thanking them for the distinguished honor done the
city by their presence, and briefly and cursorily al-
luding to the wonderful strides made by the homoeo-
pathic branch of medicine in the last few. years, con-
cluded his address.
Dr. Jones then proceeded to read a very able and
comprehensive address upon the subject of homoeo-
pathy in its various ramifications, concluding with
an encouraging peroration upon the future of the
society, and withdrawing amid applause.
The President thanked the Mayor for the wel-
come tendered.
THE PRESIDENT'S WELCOME.
He then read an address of welcome to those pre-
sent. Since the organization of the society, he said,
it had been customary to convene semi-annually,
and the lively and increasing interest taken in them
augurs well for the future. We live in an age at
once scientific and practical in its character.' Sci-
ences are generally simultaneous in their advance,
and their onward march in this century is no excep-
tion to the rule. He spoke of the relation of science
to medicine, claiming that homoeopathy was found-
ed on scientific principles. He alluded to the
growth of homoeopathy despite the sneers and ef-
forts directed against it, and then spoke of the
proper method of enhancing its value in the com-
munity. "Let us remember," said he, "our great
responsibility to the profession, and that to our ex-
ertions its success depends."
The address was warmly applauded.
SECRETARY'S REPORT.
The Secretary, F. L. Vincent, M. D., then read
the usual semi-annual report. He stated that in
1 87 1 the Treasurer made a full report to the State
Society, exhibiting a debt of $441.83, and $12.75
assets, which exhibit remains to this day. He sug-
gested a plan for soliciting contributions, which he
thought would place the society on a fair financial
basis. At present the society was in debt $383.18.
It was suggested by one of the gentlemen that
this debt be wiped out at once, and in accordance
with this, several contributions were handed in.
The President thought it would expedite business
by appointing a committee to decide what papers
should be read before the society. Drs. Fisk, Styles
and Whitney were appointed as such committee.
It was moved and adopted that others besides
members of the society be invited to read papers
on topics of interest.
MEDICAL EDUCATION.
Dr. Gray, of New York, then read an elaborate pa-
per on " Medical Education. " He described at length
the system of medical education which has been
adopted in the homoeopathic universities of the State.
The Bureau of Education were in favor of the prac-
tical instruction of students by thoroughly compe-
tent teachers. They did not believe in "cram-
ming" the student's brains with that which they
could not hold, but giving them that practical, liv-
ing instruction which must be beneficial to them.
He referred to the method of examining students
and read the regulations of the Board of Regents in
this respect. The profession thus have, he said,
fine and liberal examinations without which students
and teachers must be deficient in their work. He
suggested in conclusion that prizes of merit be
awarded to those students who attain the highest
honors.
On motion the report was accepted.
Dr. Gray suggested that a vote of thanks be ten-
dered to the Regents of the University for the pains
they have taken to carry out the objects of this so-
ciety.
He then made this motion, which was adopted:
Resolved, That the thanks of the Homoeopathic
State Medical Society be tendered to the Board of
Regents of the University for the pains they have
taken to establish the rules and regulations of the
law of 1872, asked for by this society.
EMOTIONAL INSANITY.
Samuel Worcester, M. D., presented a paper on
" Emotional Insanity," which was read by Dr. Styles,
beginning in saying there was V10 disease of so great
importance which is so little understood as insanity.
He followed with quotations from authorities on the
subject, and then advanced some of his own views.
It seemed to him that in studying insanity we should
apply the same principles that guide us in other dis-
eases of the brain. Insanity is a moral and physi-
cal disease, the latter being more frequent. What
then is the test by which insanity may be recog-
nized ? Sir John Nicholls calls insanity a delusion,
and says that he looks upon insanity and delusion as
almost if not quite convertible terms. Manger di-
vides insanity, first, in a depression and gloom with
accompanying feelings of distrust and weariness of
life, the other exhibiting itself by preternatural ex-
citement and the prevalence of angry and malicious
feelings, the latter case being most frequently met
with in our courts. He (Dr. Worcester) in his ex-
perience had met with many cases of illusion, the
208
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most of them evident, but there were others in
which there were no illusions, the latter being char-
acterized by the temporary absence of the moral
sense, and which can be traced to the sudden par-
oxysms, rush of blood, loss of appetite, absence of
mind and similar causes. Also, upon investigation,
it has been found that such persons are subject to
strong hereditary tendencies.
On motion, the paper was accepted, and the
thanks of the Society tendered to the writer.
A HOMCEOPATHIC INSANE ASYLUM.
Dr. Styles spoke on the Homoeopathic Insane
Asylum of Middletown, of which he is the Superin-
tendent. Last June it was an unfinished building,
and there was a good deal of demoralization about
it at that time. Within the past few months prog-
ress has been made toward the completion of the
first building. They have now a building of 175
feet long, four stories high. Yesterday they com-
menced a new building 195 feet long and three sto-
ries high. The new building, when completed, will
accommodate from 90 to 115, possibly more if
crowded, which, however, he does not believe in.
They had there an elegantly located farm of 250
acres, and received their water from the reservoir of
Middletown. The building will be lit by gas manu-
factured on the premises. He extended an invita-
tion to members of the Society to visit the institu-
tion. He would submit the architectural plans of
the building this afternoon.
The speaker being called upon for his specific
view as to the treatment pursued in Belgium and
other parts of Europe, pleaded that the exact sys-
tem suggested was rather beyond the limit of his
experience thus far ; but he elicited approval by the
declaration that when such instances shall present
themselves for his treatment, with the best lights
before him, he will exert his talent for their care,
and submit the result to the opinions of his co-la-
borers.
Dr. Gray moved that Dr. Styles be appointed a
committee of one for the purpose of disintegrating
the able document on insanity by Dr. Worcester,
in so far as to present the subject in its separate
parts for discussion, which was unanimously car-
ried.
Dr. W. PL Watson presented the following as
having been passed by the Homoeopathic Society
of Cleveland. Ohio, supplementing the resolution
by somewhat lengthy and patriotic remarks, advo-
cating the claims of homoeopathy by reason of its
marvelous growth and its widespread influences,
and protesting against many of the assumptions of
the allopathic branch of medicine :
Resolved, That homceopathists everywhere should
strenuously insist upon the non-violation of the
great fundamental American principle of "no taxa-
tion without representation " by sectarian monopo-
ly, either of national, state, county, or city institu-
tions supported by legal assessments, or of those
private eleemosynary institutions which derive their
support from individual contributions.
The resolution was seconded by Dr. A. E. Sum-
ner, of Brooklyn, who spoke of some of the abuses
sought to be eradicated by the resolution, denounced
the proscription of homceopathists from service in
the Police Department, and inveighed against the
allopathic monopoly of all the municipal institu-
tions of Brooklyn.
Dr. Watson urged the adoption of the resolution,
saying that the homoeopaths had now become such
a large body that they should be treated with exact
and impartial justice, and not be pushed aside by the
allopaths. It seemed to him that it was their duty
at this time to create a public sentiment. It is an
old saying that " whom the gods would destroy
they first make mad," and this was the condition of
the allopaths to-day. There was no better oppor-
tunity than the present for the homceopathists to
take a stand.
Dr. Sumner, of Brooklyn, said that he took a pe-
culiar pleasure in seconding the resolution. This is
the day of reform; it has touched every department in
the city with the exception of the Police and Health,
and the homceopathists must now come out as re-
formers. They are rapidly growing in this city and
have the countenance of many of the prominent
citizens. There is not a department in this city gov-
ernment but what is under the control of ho-
moeopathic patients. But we are not united, and
the result is to-day we are not fairly represented.
The Health Department is run exclusively by the
allopaths, and in speaking to one of the officials
there, as to when homoeopathy would be admitted,
into the department, he replied : ' ' Never. " Neither
is there a homoeopathic surgeon on the police,
though many of the force have exercised a wish for
homoeopathic treatment.
The resolution was then put to a vote and unani-
mously adopted.
THE HOMOEOPATHIC INSTITUTIONS IN THE STATE.
The Secretary read a report on homoeopathic so-
cieties throughout the State, which showed :
Hospitals 11
Insane Asylums 1
Dispensaries 16
Colleges — 4
County Medical Societies 34
The report was accepted.
A committee was appointed to draft resolutions
on the death of Dr. Simeon Cook.
The morning session was then declared adjourned,
and the members of the Society attended a recep-
tion and collation at the hospital in Columbia street.
AFTERNOON SESSION.
Pursuant to their programme, the homoeopaths
adjourned to the excellently appointed and efficient-
ly officered Homoeopathic Hospital, in Cumberland
street, near Myrtle avenue, and after partaking of a
sumptuous collation, resumed the thread of their
official labors, the proceedings of which will appear
below.
An inspection was held throughout, and the insti-
tution, though among the youngest, is certainly one
of the most cheerful and homelike of its department
in the economy of medical science. Its broad and
imposing front and rear abutting upon areas of re-
freshing turf, it is at once suggestive of airiness and
healthfulness.
Upon the first, or, rather basement floor, is lo-
cated a dispensary. This floor is further devoted to
the culinary and other needful attachments of the
establishment. Upon the second floor are spacious
apartments for reception, pharmacy and the male
surgical ward, which latter opens upon a spacious
and airy piazza, extending the width of the building.
The Medical Union.
209
In this ward are twelve beds, so widely separated as
to make the area of cubic atmosphere most ample.
The remainder of the hospital, excepting a few
rooms not yet brought into requisition, is occupied
by a male medical ward, female surgical and female
medical wards, an amputating room, and the apart-
ments of the officers, nurses and attendants in charge,
the whole comprehending a most conscientious and
humane provision for the alleviation of the sick.
In surgical operations the patient is admitted at the
Carlton avenue entrance, wheeled up the circuitous
pathway of the sward to the rear of the hospital,
lifted upon a bed, which is removed to an adjacent
elevator, and, without further removal, he or she is
deposited in the ward assigned to the sex.
Admission to the hospital is assured to patients
through the recommendation of a physician indorsed
by the alderman of the ward in which the applicant
is a resident. The Maternity in Concord street
precludes the necessity of patients of its description
being received in the gratuitous departments of the
hospital; but they are accepted in the private or pay
apartments. And it is in these latter that the Ho-
moeopathic Hospital evinces its beneficent provision
and care. There are six commodious rooms, rival-
ing in airiness, fixtures, furniture and convenience
the pretensions of many metropolitan hotels, which
are set apart for. private patients of both sexes.
These rooms are probably twenty-five by fifteen feet,
several of them, and are warmed, and have hot and
cold water. The entrance to these rooms is rigidly
private. Attached to them exclusively are closets
and a bath room. Patients are here received, nursed
and tended at all hours of the day and night, fed
according to the requirements of their condition,
and in convalescence sumptuously kept, their wash-
ing thoroughly attended to by expert laundresses,
and every care unstintingly and promptly vouch-
safed at a remuneration of $20 per week, or less
than that exacted at hotels. In this arrangement
for pay patients, the hospital indulges in a very
laudable pride, and will doubtless meet with merit-
ed popularity.
In the several gratuitous wards the hospital now
contains twenty-nine patients. An additional ward
is designed, and an accession of beds to the number
of seventy-five.
The interest of the convention seemed to culmin-
ate in the session of the afternoon, the invigoration
of a warm and bounteous feast having toned up the
homoeopaths to a degree of enthusiasm compared
with which their proceedings of the forenoon were
but cold and desultory. Apart from the copious
contributions of scientific documents, and the inci-
dent ability of discussion that followed the numer-
ous subjects treated, there were occasional sparkles
of humor. So that the interest swayed between the
erudite dissertation and the dazzle of wit with an
even balance that wore out the long session in an
intent continuity of attention, and concluded in an
exuberance of satisfaction.
The following were the papers presented and
read, and by whom, synopses of several of which
appear elsewhere :
Dr. Vincent, the Secretary, read a necrological re-
port, written by Dr. B. F. Cornell, of Fort Edward,
in relation to the life and services of Dr. Edgar B.
Cole, deceased, of Waterford. It was referred to
the Committee on Publication. Also ordered to be
placed upon the records of the Society.
Dr. Helmuth, of New York, read an able and in-
structive article on the subject of Plastic Surgery.
This article elicited discussion in which Drs. Wright,
Lord, Brown, Merrell and Lilienthal participated.
Dr. Lilienthal introduced Dr. Wm. Eggert, of
Indianapolis, Indiana, who was cordially greeted by
the President and invited to participate in the dis-
cussions of the meeting.
Dr. Houghton, of the Ophthalmic Hospital of
New York, invited the members of the Society to
visit that institution, and gave a hasty sketch as to
its capacity to accommodate patients, its workings,
&c, stating that the institution would be able, when
completed, to accommodate some 2,400 patients.
He then presented to the Society a treatise on the
subject of "Aural Diseases of Children," giving the
history of several cases which had come under his
observation in the course of his practice. This es-
say elicited remarks from Dr. Searles and others,
which were very interesting, many cases being re-
ferred to by them.
Dr. Lilienthal, of New York, read an exhaustive
essay, entitled " Differential Indication of Remedies
in Pneumonia on a Physiological Basis," giving
many illustrations in the course of his readings.
Dr. Brown, of Birmingham, made some remarks
upon the subject of the distinctive difference be-
tween moral sanity and insanity. In the course of
his remarks he made an earnest appeal for temper-
ance, and vigorously assailed the use of tobacco in
any shape. Dr. L. S. P. Lord, of Brooklyn, who
is a man of advanced years, and whose words should
have weight, indorsed the remarks of Dr. Brown,
and added an earnest, unanswerable argument in
furtherance of the cause of temperance.
Dr. Searles, chairman of the committee ap-
pointed to draft suitable resolutions relative to the
death of Dr. Simeon A. Cook, of Troy, made the
following report :
The Homoeopathic Medical Society of the State
of New York having heard of the death of Dr.
Simeon A. Cook, of Troy, one of its former Vice-
Presidents and active members, desires to record its
appreciation of his rare talents, his earnest, useful,
and in the highest sense, successful life, as well as
its deep regret at his loss, and heartfelt sympathy
with the surviving relations.
The report was received and ordered to be placed
upon the minutes of the Society.
The Society then adjourned to meet at the Ma-
ternity, in Washington street, where they were hos-
pitably received and entertained by the lady mana-
gers, Dr. Sumner, of Brooklyn, tendering the hos-
pitalities in their behalf to the President, who re-
sponded in a brief speech.
The session of the evening was a sample of Escu-
lapian abandon, marked by the absence of wine.
The Hon. W. W. Goodrich presided at the pran-
dial board, and enlivened the banquet by occasional
remarks. Prominent among the speakers were Drs.
E. D. Jones, H. D. Paine, H. C. Houghton and
others. The occasion seemed to symbolize an ex-
ceeding good fellowship among the individuals of
the society.
The convention was brought to a termination a
little after nine o'clock by two several presentations
of fraternal testimonials of esteem, the latter of
which contained the additional charm of a complete
surprise. The ex-Recording Secretary of the so-
ciety was presented with a handsome watch and
210
The Medical Union.
chain, which he reciprocally receipted for by dona-
ting to the instrument of the first presentation a
magnificent wallet. The recipient of the watch was
Dr. H. M. Paine, which was tendered on behalf of
the society by Dr. W. H. Watson, of Utica. Dr.
Watson prefaced the presentation with remarks that
were singularly well-chosen and flattering to the
donee, while narrating many of the obstacles offer-
ed to the homoeopathic school of practice, and re-
counting incidents of the long and tenacious battle
waged by a profession having the buffets of preju-
dice and the blazonry of power to overcome.
Dr. Paine responded for himself, indicating some
of the achievements of homoeopathy, and dwelling
at length upon the stupendous efforts still to be
made ere the field should be clearly theirs.
The speakers elicited applause, and at the conclu-
sion of the affair, the Homoeopathic Society of the
State of New York, with mutual acknowledgments
of consideration and esteem, adjourned until their
annual meeting at Albany, on the second Tuesday
in February, 1874.
The following are the Executive Board for the
year :
E. Darwin Jones, M. D. ; J. Ralsey White, M.
D. ; F. L. Vincent, M. D. ; N. Hunting, M. D. ;
W. Todd Helmuth, M. D. ; B. F. Cornell, M. D. ;
A. P. Throop, M. D. ; H. M. Smith, M. D. ; L. B.
Waldo, M. D. ; J. F. Gray, M. D. ; D. F. Bishop,
M. D. ; R. E. Miller, M. D. ; L. M. Pratt, M. D. ;
S. Lilienthal, M. D. ; W. S. Searle, M. D. ; H. D.
Paine, M. D. ; H. C. Houghton, M. D. ; A. E.
Sumner, M. D. ; E. M. Kellogg, M. D. ; H. M.
Paine, M. D.
NEW YORK COUNTY HOMEOPATHIC MEDI-
CAL SOCIETY.
A regular meeting was held at the N. Y. Oph-
thalmic Hospital, Sept. 10th, the Vice-President,
Dr. Blakelock, in the chair, and Dr. Minor as Sec-
retary, pro tern.
Dr. Vincent, of Troy, was invited to participate
in the proceedings. The reading of the minutes
in the absence of the Secretary was omitted. Dr.
A. T. Shuman was elected a member of the So-
ciety. l
The report of the Bureau of Obstetrics was pre-
sented; Dr. J. H. Thompson communicated a case
of pseudo-pregnancy which occurred in the practice
of Dr. L. T. Warner. [This case, in full, will be
found in the columns of this number of our journal.]
Dr. Paine said cases of this nature may be class-
ed under two heads ; the first variety embracing
those which present objective symptoms, as in
Dr. Warner's case; and the second, those where
the symptoms are only subjective, that is, exist only
in the patient's mind, and amounting, in fact, to
a perfect mania.
One case occurs to me, where every three years
the lady would spend her time and money in pre-
paring for her confinement. She lived and died
childless. In other cases, the most acute observ-
ers are unable to make out a correct diagnosis.
The last one under my observation was complica-
ted with dropsy ; and the pregnancy, which in this
case was actual, was not discovered until within five
weeks of confinement. I was one of several physic-
ians who examined a case of phantom tumor in
which all the appearances of pregnancy existed, and
it was not until we had examined the woman under
an anaesthetic that we could arrive at an accurate
diagnosis.
Dr. Goodwin said, "I believe there is but one
sign of pregnancy that never fails, and that is the
beating of the fcetal heart. Oftentimes physicians
are misled, and grave mistakes are made. Some
ten years ago, a lady in Boston was assured that she
was not pregnant up to within two days of her con-
finement."
Dr. McMurray related a remarkable case which
occurred in the practice of Dr. Bassett. A lady
married at twenty-two, and pregnant for the first
time at thirty-four, was under his careful observa-
tion. All the symptoms of pregnancy were present,
and the course was regular; at the expiration of
the nine months of gestation labor commenced.
It was rather long and tedious, and the os dilated
but slowly. While examining, the membranes were
ruptured, and the tumor suddenly disappeared with
the gush of the waters. The birth was a perfectly
formed embryo which measured only three-fourths
of an inch in length. Dr. McMurray exhibited the
specimen (which was preserved in a two-drachm
vial) to the Society. The embryo showed the indi-
cations of the eyes and the nostrils, the thoracic
extremities were represented by nipple-like projec-
tions, and the abdominal members were present as
small pimples. The urinary bladder could be seen
as a tumor which was continuous with the urachus,
and the general appearances indicated it to be an
embryo of six or seven weeks.
The doctor said the case was interesting as show-
ing how long a dead foetus may be retained within
the uterus. It was an important one, as its history
does not support the theory that the maturity of the
foetus is one of the causes of labor. It was also in-
teresting in a medico-legal point of view, for if the
husband had died in the early months of her preg-
nancy, who would have believed this to have been
other than an embryonic abortion?
Dr. McMurray also read a paper upon the advisa-
bility of the use of the forceps. He spoke at length
on the necessities for their use, the time at which
they should be applied, and of the injuries often
produced by them. The doctor took occasion to
differ with many authorities as to the indications for
their use, deducing his theories from the histories of
cases occurring under his own observation.
Dr. Vincent was called on by Dr. Paine, and
spoke warmly in behalf of the State Society. He
told of the obloquy of the pioneer homoeopaths, of
their earty struggles, and the battling for the recog-
nizance of their societies, and of the victories which
have crowned their efforts. He pointed out the
power and influence of the New York State Society
throughout the Union. He appealed to our County
Society to choose prominent, active working men
as delegates, that homoeopathy might be advanced
and its principles upheld and promulgated. The
doctor spoke further at some length and was loudly
applauded.
New Antidysenteric. — In the Vienna exhibi-
tion are shown specimens of an antidysenteric ex-
tract prepared from the pods of the Manyastus, a |
well known plant in the East Indies. It has been
found useful, not only in dysentery and chronic diar-
rhoea, but in catarrhal disorders of the uterus, blad-
der and urethra.
The Medical Union.
211
Beuiews of Boohs,
Cleaves' Biographical Cyclopcedia of Ho-
moeopathic Physicians and Surgeons. Phil-
adelphia: Galaxy Publishing Co., 1873.
The above work comes to us in the form of a hand-
some quarto, of five hundred pages, and, so far as
type, paper and binding are concerned, is an elegant
specimen of book-making. As most of the biog-
raphies have been written by the physicians them-
selves, the labors of the editor have been confined
mostly to literary revision. The work is full of
typographical errors; Dr. Jacob Beal^ey being
spoken of as James Beakley, A. Gerald Hull as
Dr. Hall, Dr.*Baner as Dr. Bauer, Jahr's Manual as
Jahn's Manual. Similar errors are found on almost
every page, showing very careless proof-reading ;
but as the work circulates almost entirely among
the physicians themselves, the errors are matters of
but little importance.
We had no idea there were so many great and
really brilliant men in our school. As we turn over
the pages and there pass before our eyes the splen-
did galaxy of talent in which our profession is
linked with the great and good in all the past— cel-
ebrated divines, men of science, heroes of war and
heroes of peace — our wonder is, not that our school
has accomplished so much, but that instead of
moving on so grandly in its triumphant path, it
has not already conquered the medical world, and
is now dictating terms to the vanquished.
As we turn over page after page and read the
record of great deeds, of splendid works done for
science and humanity, of the maiden sword, flash-
ing in the light of transcendent genius, and we
catch the sight of elegant country-seats embowered
among shady trees, where the fluttering leaves fan
away care from the tired and aching brow, we say,
surely, merit is not without its reward, even in this
world. We read on, our brain reeling and our eye
dazzled by the glittering array, until at length
there flashes before us a royal form in whose veins
flows the blood of the Guelphs, and before his
kingly looks we throw down our pen and fold our
mantle about our face, thrilled with the thought
that, but for the numerous progeny of Victoria, a
Homoeopathic physician might sit on the throne of
England.
Ophidians. By S. B. Higgins. New York :
Bcericke & Taffel.
The author divides snake poisons into two classes,
each with a ' distinct type of action. The cobra
poison when introduced into the blood causing it to
coagulate firmly in a very short time, and the rattle-
snake poison which causes the blood to remain per-
manently diffluent, are illustrations of the separate
types of action. All known snake poisons, he says,
belong to one or the other of these two classes ;
and most of them, to the rattlesnake class. The
cobra venom, he thinks, attacks the corpuscles of
the blood, while the rattlesnake venom attacks the
plasma. Dr. Higgins believes that the antidote to
the ophidian venom is in the gall of the reptile
itself, and brings many facts to support his theory.
To men of our profession the work is one of ex-
ceeding interest, and will be found to contain scien-
tific facts and general information of rare value.
Eighteenth Annual Report of the Bond
Street Homoeopathic Dispensary ; Otto
Fullgraff, M. D., Founder and Manager.
According to its tabulated statement, there have
been treated in this institution since 1856, when it
was founded, 287,661 patients, and 617,626 pre-
scriptions have been dispensed. Within the past
few years, while no class of diseases have been neg-
lected, special attention has been directed to the
treatment of nasal catarrh and throat diseases.
The very beautiful instruments recently brought
into use, by means of which medicated spray may
be brought in contact with every part of the
throat, larynx and nasal passage, have very much,
in skillful hands, simplified the treatment of these
otherwise obstinate and sometimes incurable dis-
eases. Dr. FullgrafFs long and successful experi-
ence in the treatment of this class of troubles, has
enabled him to place in his dispensary not only the
best instruments in general use, but to add mate-
rially to the completeness of the list by important
improvements and inventions of his own.
Mechanism of the Ossicles of the Ear. By
H. Helmholtz, Professor of Physiology in the
University of Berlin, Prussia. Translated by
Albert H. Buck and Normand Smith, of
New York. Wm. Wood & Co., 1873.
This book is a short and clear essay upon the phy-
siology of the reception and transmission of sounds
to the auditory nerves and central organs of per-
ception. It is written in a concise and terse style,
and all of the theories which are advanced are de-
ductions carefully drawn from the mathematical
and philosophical laws which govern all bodies.
The author opens his subject with a chapter on the
results due to the small dimensions of the auditory
apparatus. He says : " The most important step in
advance made by Edward Weber in the theory of
the transmission of sound in the ear seems to me
to be the view that, in the transmission of sound-
vibrations, the bones of the ear and the petrous
portion of the temporal bone are to be considered
as solid, incompressible bodies, and the fluid of the
labyrinth as an incompressible fluid. He rightly
declares that in the case of these bodies and fluids
there can be no question as to the transmission
of waves of condensation and rarefaction, but that
the bones of the ear must be considered as solid
levers, and the fluid of the labyrinth as a mass only
to be moved as a whole. "
Taking the above as a theorem, he proves it by
explaining the laws respecting the form and mode of
vibrations of waves of sounds, their length, and the
conditions of displacements of the ultimate parti-
cles of the vibrating body. He* says "that we are
to conclude that in the vibrations of the auditory-
apparatus of the bones of the ear and of the pet-
rous bone, caused by the tones ordinarily apprecia-
ble by the ear, the particles of each of these small
masses undergo displacements among one another
which are infinitely small compared with the ampli-
tude of the sound-vibrations producing them; that
is to say, that they act very nearly like absolutely
solid bodies. And further, as long as the periods
of vibration of the tones which the bones of the
ear must transmit are very great compared with
those of the bones themselves, so long will the lat-
ter act, practically, as absolutely solid bodies."
212
The Medical Uniott.
In the next succeeding chapters he makes some
remarks upon the anatomy of the ear, before pass-
ing on to the mechanism of its apparatus, with a
view of giving prominence to a number of small
points, which are merely noticed and then passed
over, as a rule, by the anatomist, but which gain
importance in a more thorough investigation of
their physiological bearings.
The chapters on the attachments of the hammer,
and of the anvil, are lucidly written, and give very
beautiful and clear ideas of the action of these
bones.
He illustrates his views with plentiful mathe-
matical demonstrations, and presents a clear and
well-defined picture of his subject. The book
is well illustrated, and the topic so well handled,
that we may reckon the distinguished physiologist
among the deepest scientific thinkers of modern
times.
Report of Columbia Hospital for Women
and Lying-in Asylum, Washington, D. C. By
J. Harry Thompson, A. M., M. D., Surgeon-
in-Chief.
We are indebted to the Secretary ofjhe Interior for
this exceedingly valuable and interesting report. It
forms a quarto volume of 420 pages, is carefully pre-
pared, and the more important operations illustrated
by engravings.
The number of patients treated during the year
was 4,576; of these, 3,708 have been cured, 561
relieved, and 2 1 have died. The surgeon has opera-
ted fifty-three times for the cure of lacerated or rup-
tured perineum, and in each with entire success.
In the hands of a skillful surgeon, this operation is
one of the simplest and most successful operations
in obstetric surgery.
The plan laid down by Baker Brown was followed
in some of the important stages, but the operator
prefers the plan first suggested by Dr. Van Buren,
of paralyzing the sphincter, to that of Baker Brown,
who divides the sphincter ani on either side of its
coccygeal attachments. The sphincter is paralyzed
by introducing the thumbs into the anus, seizing the
nates on either side, making gradual traction, until
the thumbs touch the tuber ischii. This paralysis
remains for two or three weeks, but is never followed
by permanent loss of power. In the after-treatment,
instead of keeping the bowels constipated, as rec-
ommended by Baker Brown, he secures a soft
passage every day. He washes out the vagina twice
a day, with the following prescription : IjL Aqua
Fura I 1 ss. Glycerine, | ss. Acidi Carbolici gr.
viii. If the parts become odematous, as they are
likely to do twelve or eighteen hours after the ope-
ration, he makes several punctures with the lancet,
liberating the serum, and thereby relieving the
tension.
Dr. Thompson's operation or vesico-vaginal and
recto- vaginal fistula is the same as practised by all
good surgeons at the present day. In vaginal
rectocele he differs materially from Dr. Sims, and
claims that while Sims' method is hardly ever suc-
cessful, with his own method he never fails. Dr.
Sims takes a thick fold of the hypertrophied mem-
branes, and tries to hold them by the adhesion of
one-quarter of an inch of mucous membrane. Dr.
Thompson cuts out the whole of the membranes in
excess, and unites the edges by the entire thickness
of the tissues, making a strong firm cicatrix forming
a raphe, which gives increased support to the uterus.
The treatment of cystocele is similar to that adopt-
ed for the cure of rectocele; the tissue, being re-
moved from the anterior instead of the posterior
wall, requires much more careful dissection. Twelve
cases are given, all of which were successful.
Fifty-seven cases of prolapsus uteri were treated ;
about one-third of which were complicated with
rectocele and cystocele, and the experience obtained
in the treatment of these cases convinced the author,
that to effect a radical cure when the cervix is
hypertrophied — the enlargement consisting of con-
nective tissue, and irreducible by topical applications
— it is necessary to amputate the whole of its vagi-
nal portion, otherwise, the vagina wiH yield in time
to the disproportionate weight and the uterus again
escape externally. We are glad to see the author
condemns the indiscriminate use of pessaries as not
only generally useless, but productive of positive
harm.
In dilating the os for explorations and treatment
of the inside of the womb, he recommends in all
cases where either the sponge or sea tangle tent is
used, first to divide the fibres around the internal os.
By adopting this plan, he has never had any trouble
from their use. Without this precaution, the free
use of tents often gives rise to tetanus and severe in-
flammatory action.
In reference to carcinojna of the womb the au-
thor says that as the result of a large experience,
he is convinced that by judicious treatment, in a
large number of cases, the exciting cause can be
removed and thus an attack prevented. Cancer
rarely if ever attacks the uterus uninvited. It
comes at the invitation of oft repeated irritations,
congestions and inflammations superinduced by
violation of the plainest physiological laws.
From a diligent examination of the investigations
of others, and a careful analysis of a large number
of cases which have come under his own observa-
tion, the author is induced to believe — First : That
cancer is not constitutional in its origin, but the re-
sult of a slowly transpiring interstitial inflammation
dependent upon local irritation. Secondly : That
there is no specific cancer-cell, the cells found in
the connective tissue-stroma being altered epithelial
cells, or the white corpuscles of the blood, their
different appearance in different forms of cancer
being dependent upon the stage of the disease and
the organ in which it is developed. Thirdly : That
the probability of secondary cancer occurring after
the ablation of a primary tumor depends upon the
richness of the part in lymphatics, and the stage of
the disease.
Frequency of the Disease. — The absence of a
proper system of registration in this country pre-
cludes the possibility of furnishing reliable statistics
of this disease. The entire number of deaths oc-
curring in England, Ireland and Scotland from
1851 to 1871 was 124,740; of these, 31,816 were
males and 92,924 females. The death rate from
cancer in Paris is largely in excess of London, and
deaths from malignant diseases are more common
in large cities than in rural districts. If cancer
were the result of general blood-poisoning, if a pre-
existing cachexia was necessary for its development,
we should naturally look for an increased number
of cases among the lower classes, who inhabit
poorly ventilated houses in unhealthy portions of
The Medical Union.
213
large cities, as we find all other blood diseases fear-
fully increased among that class of population, but
the reverse is the case. Persons of lymphatic tem-
perament are much more prone to the disease than
those of sanguine or sanguineo-nervous. The
weight of evidence, from carefully collected statis-
tics, show, that the disease is not hereditary. In
the treatment of this disease we are unfortunate
in the majority of cases, on account of the advance
it has made before we see it restricted to palliative
treatment. An operation for its removal, to be suc-
cessful, must be performed early, before the altered
epithelial cells, or white blood corpuscles,have escaped
into the lymphatics and gotten beyond our reach,
and by their aggregation and multiplication in con-
tiguous parts given rise to secondary disease.
In the palliative treatment, the author has found
Bromine more effective than any other caustic in
arresting rapidly destructive ulceration. It requires
to be used with great care to protect the sound parts
from its corrosive action. To destroy the fetor of
the discharge he uses Bromo-chloralum. Carbolic
Acid is equally effective, but its unpleasant odor
makes it objectionable. In relieving pain he has
found nothing so efficient as Morphine. Conium
answers very well in the early stage of the disease.
Want of space prevents our noticing various uterine
diseases illustrated in the work, and we pass to the
Department of Diseases of Children. In the dis-
cussion of the various diseases of infancy but little
new is advanced either in pathology or treatment.
In regard to diet we find the same general ideas
which we advanced in a recent number of the jour-
nal in our article on the " Perils of Infancy," and
which are generally received by the best pathologists
and most careful observers of the present day.
When the child will not bear a milk diet, animal
broths and those farinaceous preparations should be
used which contain as little starch as possible, be-
cause starchy aliments are indigestible on account
of the absence of digestive power in the salivary,
pancreatic and enteric juices of young animals, re-
turning to milk or cream diet again as soon as the
child will bear it. The writer does not believe in
Mercury in the treatment of any of the intestinal
and gastric disarrangements of children. He says,
" If it is useful, it is through its alterative, purgative
or cholagogue action. The very nature of the dis-
ease clearly contra indicates any demand for altera-
tives, and morbid anatomy has failed to reveal con-
ditions calling for its cholagogue action." We are
afraid the doctor summarily dismisses what might
be, if he understood its proper use, one of the most
potent weapons in his armory for the treatment of
some of these diseases. Further on he seems to
have a glimmering of the fact, for he says: "I
admit it will occasionally allay gastric irritability,
stop vomiting, and change the acid secretions
when all things else seem to fail. But is the effect
not due rather to its mechanical than its thera-
peutic action ?"
The first indications to be met with in medicines,
he says, is to allay the gastro-intestinal irritability,
and he finds no agent comparable as a sedative to
the Sub Nitrate of Bismuth, given in five-grain doses
in children of one year. To quiet the peristaltic
action he finds no remedy equal to Opium, carefully
watching its action for fear of brain symptoms.
In matters of pathology, hygiene, and food, and
in all matters where their conclusions are the result
of scientific experiments, our allopathic friends
are generally fully up to the times, but in the dis-
eases of children, especially, they are lame and
halting in their therapeutics, and could learn many
valuable lessons from our school, which has done
what little there has been done towards exalting
therapeutics to the dignity of a science. It is a pity
that prejudice and bigotry should prevent any class
of physicians from availing themselves freely of the
scientific researches and experience of men of every
school and every creed. We can mutually help
each other, and every honest searcher after truth
can bring, as the result of his own experience, some
interesting fact or new truth. The attention of our
allopathic friends has been more particularly turned
to physiology and pathology, while our researches
have been more in the line of therapeutics. In
these departments great advancement has been
made, and while we freely use the labors of pathol-
ogists and physiologists as helps in our therapeutics,
we should be glad if our allopathic friends would be
as successful in treating disease as they are in their
pathological investigations.
The Physiology of Menstruation.
_ Dr. Kundart, of Vienna (Rokitansky's senior as-
sistant), has just published an account of cer-
tain researches of his upon the anatomical condi-
tion of the uterine mucous membrane before, during,
and after menstruation. He examined the mu-
cous membrane of the human uterus in the
interval of menstruation, immediately before the
hemorrhage, during the hemorrhage, and after
it had ceased. He points out the peculiarities
of the mucous membrane of the uterus in a state
of rest. There is no submucus tissue, and the mu-
cosa comes in immediate union with the muscular
layer. Its matrix is peculiarly rich in round or
s pindle-shaped cells. The glands, which it is known
to possess, in great numbers, are lined, like the free
mucus surface, with ciliated epithelium. This con-
dition is materially altered at the monthly period of
uterine activity. The mucous membrane is* smaller,
loose, thick, and almost diffluent, covered with
a whitish or bloody mucus finely injected at
spots, and in many cases uniformly colored of a
deep red. A microscopical examination reveals in-
creased abundance of the cellular matrix, especially
at the surface, with great elongation and dilatation
of the glands. He discovered that the condition of
the uterus just described probably precedes the oc-
currence of the discharge of the ovum and the men-
strual flow by several days. He thinks from these
observations that the uterus is prepared for the re-
ception of the ovum a certain time before the rup-
ture of the Graafian vessicle. While the rough
characters remain as described during the menstru-
al flow, with the addition of the oozing from the
surface, and for a short time after it has ceased,
careful examination reveals a very remarkable
change in the microscopic appearance. The cells
of the stroma and the vessels, as well as the epithe-
lium of the glands and surface, are dull in appear-
ance and filled with fat granules. The question oc-
curs, " What is the relation of the hemorrhage to this
fatty degeneration of the cells and vessels ? " Kun-
dart does not believe the hemorrhage causes the fatty
change but is caused by it. He speaks of the fatty
change which is known to occur at the end of preg-
214
The Medical Union.
nancy and considers the two phenomena homo-
logous. He points out the improbability of the
cause of the flow being found in congestion, as this
occurs so frequently without hemorrhage. The
fatty change is most abundant at the surface of the
mucosa, where the bleeding takes place.
According to Kundart, at the monthly period of
uterine activity, we have swelling of the mucosa,
fatty change in the cells and vessels, vascular rup-
ture and hemorrhage. With blood much altered
epithelium is thrown off, but not the whole mucosa.
It is a short time after the cessation of the menses
before the mucous membrane has returned to its
condition of rest. In inquiring into the physiologi-
cal relations of the three processes — the swelling of
the mucosa, the discharge of the ovum, and the
flow of menstrual blood — Kundart insists that the
first mentioned of the three is the first in the
order of time, and it is almost certainly the prepa-
ration for the reception of the ovum. It is much
more improbable that the uterus, during the men-
strual flow, is in a condition suitable for this func-
tion— with a retrogressive process going on in the
mucosa, its vessels ruptured and its surface dis-
charging blood. It is even more improbable that
the mucosa, in this state of degeneration, will, in the
descent of the ovum, 'take on a totally opposite pro-
cess and become highly developed. The type of
the impregnated uterus is seen in the active uterus
when the mucosa is swollen and menstruation not
yet commenced. If the bleeding does commence,
it is a sign that the ovum has perished and that the
mucosa is returning to a state of rest. Thus we ar-
rive at the highly important conclusion that a devel-
oping ovum or growing embryo belongs not to a
menstrual period just past, but is one just prevented
by fecundation. Gynecologists are already changing
their opinions as it regards the time of conception
and the duration of pregnancy, and if the state-
ments given by Kundart are correct, they will lead
to a still further important modification of matters
which were once considered settled.
Ahn's Rudiments of the German Language,
and Ahn's First and Second German Books.
Published by E. Steiger, New York, 1873.
A KNOWLEDGE of the German language is to be con-
sidered, for the physician of to-day, not only as an
• accomplishment as formerly, but as one of the ne-
cessities which the advance of our progressive
science demands from its devotees.
Germany now takes the lead in the world of
sciences and her schools offer the greatest opportu-
nities for pursuing its study in its various branches.
With the discovery of the microscope, and the reve-
lations it has given, medicine has become allied to
the exact sciences through the patient investiga-
tions of the German physicians. They have made
nearly all the recent discoveries in histology and
pathology, and to them we owe the generally ac-
cepted theories of the action of the various forms of
disease upon the human organization. In all the
specialties, as that of the eye, the ear, the throat,
the skin, Germany stands foremost. Her universi-
ties are richly supported by the Government, and
they have pursued the wise policy of filling its pro-
fessorial chairs by the leading scientists of Europe.
Vienna has the most extensive hospital (number-
ing over twenty-two hundred beds), the greatest
amount of clinical material, and the largest corps of
instructors of any university in Europe. The ad-
vantages for the general practitioner are unsur-
passed, and over two thousand students congregate
there from every portion of the globe. She may
well be called the Mecca of Medicine.
The German language is rich in medical litera-
ture, and it is stored with treasure. The names of
Langenbeck and Billroth, of Frerichs, Traube and
Bamberger, of Arlt, Jaeger and Politzer, and Von
Troeltsch, of Scanzoni, Vogel, Hebra, Koelliker,
Rokitansky and Virchow, and hosts of others are fa-
miliar to us all. We are proud that medicine has
enrolled upon her roll of honor the names of Von
Graefe, Oppolzer and Niemeyer, and they have be-
queathed to us stores of wealth. Every medical
student must realize the great privilege of being
able to catch the thoughts of these great teachers
and leaders as uttered from their lips, or as they
emanate from their pens.
Ahn's method consists of a simple, easy, and
complete series of practical exercises illustrating the
principles of the German language. It is attract-
ively arranged, and affords an easy and rapid way
of learning to speak the tongue. It is elegantly
printed, and we bespeak for it a widespread success.
Scientific Cleanings*
Comparative Longevity of Married and
Single Life. — Dr. Bertillon, in a paper recently
read before the Academy of Sciences in France, gives
the following interesting facts, gathered from Hol-
land, Belgium and France. Between the ages of 20
and 25, in 1000 married men there are 6 deaths ; in
1000 bachelors 10 deaths ; in 1000 widowers 22
deaths. Between 35 and 40, deaths in the same num-
ber are married men 7; bachelors 13; widowers 17.
Through a series of years the same results are ob-
tained. On the side of women, there is increased
mortality among the married over the single up to
the age of 30; after this the married more than
make up the loss, so that when the whole number
of years is counted, the gain is found to be in favor
of the married. Thus in France, from 15 to 20, the
deaths in 1000 unmarried women are something over
lYz ; and among the married between these ages
they are 1 1 % ; from 20 to 25 the deaths of sii\gle
women amount to 8*4, and of wives to 10. Here a
favorable turn is reached for the married as 30 is
approached, and they show for the rest of their lives
15 to 16 deaths in the 1000 to 26 and 27 of the un-
married. Widows, like widowers, show a remark-
able increase of mortality.
Oxide of Zinc in Diarrhozas of Infancy. —
Dr. Brakenbridge, from a long experience in the
Edinburgh Royal Hospital for Sick Children, has
found great benefit, in the diarrhoeas so common
among children, from the oxide of zinc. Careful
reasoning and close observation have led him to
conclusions which we reached long ago by the more
sure and scientific process of drug proving. His
conclusions are thus briefly stated : "F irst, " he says,
" the disease depends chiefly on a weak and too im-
pressible state of the nervous centres presiding
over alimentary secretion. Secondly, it is corre-
lated to convulsions and other spasmodic diseases.
Thirdly, it is accompanied by hyperasmia of the in-
testinal canal. The zinc, he thinks, meets all these
The Medical Union.
215
conditions, as a tonic, being to the nervous system
what iron is to the blood. He has also found it
beneficial in cases of diarrhoea of phthisis occurring
in children.
Tongueless Speech. — It has generally been
supposed that when the tongue is removed speech
is destroyed, but there are many instances on record
of tongueless speech. Prof. Huxley narrates a "case
where the tongue had been removed, and yet the
person could speak with but little difficulty. In A.
D. 484 sixty Christian confessors had their tongues
cut out by order of the Vandal conqueror, but in a
short time they were preaching again. A case is
narrated in the 44th volume of the Philosophical
Transactions where the girl lost the entire tongue
from a cancer, which also destroyed the mouth,
and yet her power of speech was uninjured. The
profession is familiar with a recent case, where, in a
man seventy-two years old, the tongue and lower
jaw were removed in order to get rid of a cancerous
mass. Two months after the operation, speech was
restored to some extent. The presence of the
tongue is not absolutely essential to speech, since
there are other organs in the mouth which tend to
produce articulate sounds and which can supply the
lack of it. The uvula, the nares, the palate, the
teeth and the lips are all so much concerned in
speech that whole -nations are distinguished by the
manner in which they make more or less use of one
or other of these parts.
Atropine as an Antidote to Opium. — In
regard to the treatment of cases of opium poisoning,
the following are the conclusions arrived at by
Dr. James Johnson, Medical Officer to the Chinese
Hospital at Shanghai.
1. " That in mild cases, when the patient is
seen within one or two hours after taking the poison,
and is conscious and able to move about, with pupils
uncontracted and movable, the ordinary treatment
by emetics, etc. , will usually suffice for recovery ;
but the greatest watchfulness and care are necessary,
for even in the mildest cases, dangerous symptoms
speedily set in. As a rule, whenever there is great
drowsiness, with contracted pupils, after the evacu-
ation of the contents of the stomach, and moving
about of the patient, it is advisable to bring the
system under the influence of Atropine at once.
2. " The state of the pupils is of the first impor-
tance. Whenever they are firmly contracted to a
pin's point, there is danger ; although the patient,
for the time, may seem but slightly affected, sooner
or later coma inevitably comes on. It is, therefore,
advisable in such cases, to use Atropine at once.
3.. " That in cases when the nervous centres do
not respond to the cold douche, and moving about
the patient, it is not only useless, but mischievous,
to persist in attempts to drag the individual about,
as it only increases the exhaustion, which is one of
the greatest dangers in cases of opium poisoning.
The treatment for such cases is to place the patient in
the horizontal position and inject the Atropine sub-
cutaneously, and, if necessary, assist with artificial
respiration, and, in case of exhaustion, to strengthen
the circulation by applying warmth and counter-
irritation to the limbs, and by the administration of
stimulants, such as coffee, ammonia, brandy, &c,
internally.
4. "That in all cases of profound coma from
opium poisoning, with perfect insensibility, firmly
contracted pupils, and stertorous breathing, Atro-
pine should be exhibited at once, and the patient
carefully supported afterwards by the administration
of coffee, ammonia, and stimulants.
5. " That when the system is fairly under the
influence of Atropine, with respiration tranquil,
however slow it may be, it is undesirable to interfere
by artificial respiration, as it only embarrasses the
breathing and interferes with the tranquil sleep
which usually follows the exhibition of Atropine."
Condition of the Arteries of the Tegu-
ment in Fever. — In an article on the above (in
Cent, fur die Med. Wissensch. No. 12, 1873) by
Dr Ch. Baiimler, the following views are expressed :
During the period of heat in intermittent fever, du-
ring the first week in abdominal typhus, as also in
variola, pneumonia and traumatic fever, there exists
a condition of dilatation of the tegumentary arteries,
with more or less redness of the skin. If a mark is
made with the nail on the skin, it shows itself by a
pale line which spreads over a certain extent, and
diappears only after about four minutes. This phe-
nomenon depends on morbid excitability of the
vessels, which likewise manifests itself by rigor
under the influence of the slightest current of air.
This condition of dilatation of the vessels persists
only as long as the power of impulsion of the heart
is preserved, and ceases to manifest itself after the
first few days in grave or very intense states of fever.
It cannot be attributed to paralysis, the least excit-
ing cause being quite enough to determine ener-
getic contraction of the vessels as has been shown
above.
PODOPHYLLIN IN INFANTILE DIARRHOEA. —
Dr. Deck, of New Zealand, speaks very favorably
of Podophyllin in infantile diarrhoea. The chil-
dren, he says, are worse in the morning and fore-
noon. If the attack is severe they lie in a restless
drowsy state, with half-closed eyes, constantly
moaning, and rolling the head from side to side dur-
ing the forepart of the day ; but they often cheer
up a little in the afternoon. The head is hot, some-
times perspiring during sleep, and the cheeks
flushed: great thirst for cold water and frequent
retching without bringing up anything. The diar-
rhoea is generally worse in the morning on waking
and in the forenoon, and is usually better at night.
The evacuations are sometimes preceded by colic,
in which the child clenches its hands and straight-
ens itself out. There will often be three or four
movements of the bowels within an hour after the
child wakes, each one very profuse and exhausting.
They generally come with a sudden gush and are
very fetid and offensive. The bowels often act after
food and sometimes while the child is being washed.
The appearance of the motions vary. In diarrhoea
they are generally watery, sometimes like dirty
water, soaking the napkins through, and with a
meal-like sediment ; sometimes greenish in color,
generally profuse, frequent in the forepart of the
day, gushing and very offensive. In dysentery they
consist of greenish yellow, slimy or bloody gelatin-
ous mucus alone, or mixed with a fecal motion,
but there is also much tenesmus and often prolapsus
of the bowels. The tongue is sometimes, but not
always, coated.
The most characteristic Podophyllin symptoms
are the profuse, offensive, sudden stools, with morn-
ing aggravation, combined in serious cases with the
Belladonna -like head symptoms.
2l6
The Medical Union.
Mercurius is generally indicated in dysentery.
Like Podophyllin, the stools are generally slimy mu-
cus, bloody, greenish, with tenesmus; but, unlike Po-
dophyllin, they are generally scanty, with very little
smell. The aggravation is generally at night in-
stead of the morning. He recommends Podophyl-
lin in the lower dilutions.
3sfew$ 3iem$*
Harrisburg Hospital. — A slight tempest in a
teapot has recently occurred in the Harrisburg Hos-
pital. The managers passed a resolution that a
supply of Homoeopathic medicines be obtained, and
patients who preferred that treatment might be treat-
ed by physicians of that school. At this the staff of
" regular" physicians in attendance took umbrage,
and sent in their resignations. Not satisfied with the
preparation of this terrific " bomb-shell," a special
meeting of the County Medical Society was called,
which approved of the course taken by the physi-
cians, and to still more strike terror into the hearts
of the managers, pledged themselves not to accept
any position in the hospital unless each and every
member of the late staff be re-elected by the mana-
gers, and all other practice but that of the " regular"
school of medicine be ignored.
Having thrown this terrific bomb-shell right into
the hospital, they calmly waited to see the managers
on their knees, but what was their astonishment to
find themselves hoisted with their own petard. Their
resignations having been unanimously accepted, and
Drs. J. J. Applebaugh and J. L. McRechan, both
highly respected physicians, appointed in their
place. The managers assure the public that the
institution will be conducted on the principles of
universal charity to all without regard to creed or
race, and unfettered by any medical school. At our
last advices, the institution had severed the cords of
the " regulars " and is in a flourishing condition.
New York State School for Training Nur-
ses.— The School Department of the Brooklyn Ho-
moeopathic Maternite for the education and training
of nurses will open its first semi-annual course of in-
struction on Tuesday, October 7th, 1873, at the
Maternite, 48 Concord street, Brooklyn, N. Y.
The school year is divided into two terms, of six
months each, to commence on the first Tuesdays of
October and April, respectively. The first half of
each term will be devoted to lectures and clinical in-
struction : the second half to the practical details of
nursing.
Applicants for admission to the school should ap-
ply personally, or by letter, at the Maternite, No.
48 Concord street. They must be not less than
twenty-one, nor more than forty years of age ; and
must furnish satisfactory references as to their mor-
al character and general health. They must also
be able to read and write the English language, and
sign an agreement to remain six months. They
will then be received into the Maternite, and
boarded and lodged at the expense of the institu-
tion during the entire course of instruction.
The students will be under the authority of the
Matron, serve as nurses under her direction, and
subject at all times to the rules of the house.
The Matron, under the direction of the School
Committee, may discharge them at any time in case
of misconduct or inefficiency; but no moneys shall
be refunded for any cause except that of permanent
physical disability.
The Maternite will provide all necessary text-
books, models, instruments, etc., for the use of the
pupils, free of charge.
At the close of each course, such nurses as shall
pass a satisfactory examination by the Medical
Staff, will receive the Maternite's certificate of re-
commendation, to be renewed, however, at the ex-
piration of each year, for three successive years,
after which a perpetual diploma will be granted to
such as prove meritorious.
The fee for the course is twenty-five dollars, inva-
riably in advance.
It is confidently believed that there will be an im-
mediate and constant demand for the services of our
graduates at very remunerative prices.
Mrs. H. W. Sage,
Chairman of the School Committee.
Mrs. R. C. Moffat,
First Directress of the Maternite.
A. E. Sumner, M. D.
Medical Director.
Course of Instruction. — The course of instruction
is divided into three divisions: The first division
comprises lectures on Anatomy and Physiology ;
lectures on general Hygiene ; lectures on Food and
Diet. The second division comprises lectures on
the Management of Labor ; the special duties of
the Lying-in Nurse, etc. ; lectures on the care of in-
fants in health and disease; bedside instruction.
The third division embraces lectures on Uterine
Diseases ; the recognition of uterine abnormalities,
hemorrhage, miscarriage, etc. ; lectures on the Cu-
linary Art ; clinical instruction.
Medical Staf.—Wm. M. L. Fiske, M. D., Anat-
omy; Wm. Briggs Garside, M. D., Physiology;
D. A. Gorton, M. D., Institutes of Hygiene; R. C.
Moffat, M. D., Obstetrics; A. E. Sumner, M. D.,
Infancy; Wm. S. Searle, M. D., Uterine Patholo-
gy; J. F. Oaks, M. D., Clinical Instruction.
William Tyler Smith, M. D., F. R. C. P., died
June 2d, of apoplexy, aged fifty-eight years. He
was a man of great industry and rare intellectual at-
tainments. Notwithstanding weak bodily health,
he rose to great eminence in his profession. His
works on obstetrics are among the best which have
ever been written. He was the author of Parturi-
tion and the Principles and Practice of Obstetrics ;
The Periodoscope, with its Application to Obstetric
Calculation in the Periodicites of the Sex ; Scrofula,
its Nature, Causes and Treatment ; . Treatment of
Sterility by Removing Obstructions in the Fallopean
Tubes ; Pathology and Treatment of Leucorrhcea ;
A Manual of Obstetrics, &c.
The following are the officers of the American
Association for the Advancement of Science, elected
at Portland, Me., for the ensuing year: Dr. Le-
comte, of Philadelphia, President ; Professor C. L.
Lyman, of New Haven, Vice-President ; Dr. A. C.
Hamlin, of Bangor, General Secretary; W. S.
Voux, of Philadelphia, Treasurer. ■
Leipsic University. —According to the Frank-
fort Journal, the number of students during the
present summer months amounts to 2,700, of which
99 are students of medicine.
Prof. Romberg, the distinguished author of the
famous work on "Diseases of the Nervous System/'
died at Berlin, June 16th.
The Medical Union.
217
iDriginal Articles.
THE TOPICAL ACTION OF IODOFORM.
By W. N. Guernsey, M. D.
Case I. — Mr. C. called upon me in November,
1 87 1, for relief from venereal trouble. Upon ex-
amination, I found situated upon the dorsal surface
of the penis, a soft, non-infecting chancre, the size
of a silver quarter of a dollar piece. It was circu-
lar in shape, and the circumference was well defined,
presenting the sharply cut edges, and the under-
mined appearances which are so characteristic of the
simple chancre. The surface of the sore was cov-
ered with a dry and dark-colored slough, yet the
inflammatory action was not sufficiently intense to
class the case as one belonging to the sloughing
phagedenae. It was indolent, and had become so
from the meddlesome and irritative treatment which
it had undergone.
The chancre had been contracted some two
months or more previously. It was first cauterized
with nitrate of silver, then another physician applied
the fuming nitric acid, and another sulphate of cop-
per, while a fourth sprinkled it with calomel, and
as it continually grew worse, nitric acid was again
applied. Still further treatment was pursued, but
it was all of no avail ; and the patient, dejected and
despondent, resolved upon another change of treat-
ment, and presented himself to my care.
I ordered the sloughs to be removed by the aid of
warm cataplasms, and then the sore to be sprinkled,
morning and evening, with powdered iodoform. In
a few days afterwards, the patient was called out of
town upon business, and I lost sight of him for sev-
eral weeks. Immediately upon his return he called
upon me, as he felt it his duty, he said, to tell me
of the rapid cure I had effected in his case. " The
powder dried up the sore like magic," he added,
" and within a fortnight I was entirely well."
Case II. — Mr. W. presented himself to me in
the summer of 1872, affected with a simple, soft
chancre, situated in the furrow behind the glans
penis. He had contracted it some five or six days
previously, and it presented the ordinary appearances
of an uncomplicated sore. Its circumference was
circular, its margins sharply cut, as if by a punch,
and somewhat undermined, and the floor of the
ulcer was spongy and covered with grayish green
tenacious matter. Powdered iodoform was ordered
to be continually applied, and in eight days the
sore was entirely healed.
My attention was first called by Dr. E. Guernsey,
some two years since, to the marked curative effects
of iodoform in venereal ulcerations. I was aston-
ished at the rapidity with which, many times, the
ulcers were healed under its use. If it was as effi-
cacious as other remedies, there were many reasons
why its use should be more preferable to the ordi-
nary methods of treatment then in vogue.
Iodoform or teriodide of formyl, like the terchlo-
ride of formyl, or chloroform, possesses anaesthetic
properties, although inferior to those of the latter.
M. G. Voelker and M. Demarquay have availed
themselves of its anodyne properties b.y using it ex-
tensively in cancer of the uterus, and in diseases of
the bladder and prostate gland, where it has given
great relief. Taken internally in large quantities,
it produces narcotic effects, and is said to be very
useful in neuralgia, aside from its alterative action
upon scrofulous or syphilitic diatheses.
These properties commend it to the physician.
Hitherto, most practitioners have deemed it neces-
sary to destroy the virulent specific character of the
venereal ulcers, and to convert them into simple,
non-contagious wounds. The unsparing use of the
caustic is recommended by Ricord in the most
forcible language. " It is necessary," he says, "to
kill the chancre upon the spot. Therefore, direct
your attention to the most violent escharotics. And
in order to obtain from this method the most suc-
cess it can give you, it is necessary that you should
employ it in all its severity. Then, no slight cau-
terization : what you seek to produce is an energetic
and deep cauterization, a veritable destruction."
With the use of iodoform, we are spared the un-
pleasantness of seeing our patients writhe and
shriek in agony, or fall down in syncope under the
application of the caustic. From its anaesthetic
properties, it commends itself in the relief it brings
to the painfulness and irritability which is fre-
quently coincident. And, further, being of an or-
ganic nature, and non-irritant, are qualities favor-
able for its absorption, and for its acting as an ab-
sorbent and desiccant.
I began to use it quite extensively, but soon
learned that it did not supersede the caustic. Clin-
ical observation proved the remedy to be far more
efficacious than the customary cauterizations and
astringent washes ; yet, not every case yielded
equally rapidly to its curative action. Upon fur-
ther investigation, I found it to act most benefici-
ally where the suppuration was only inconsiderable,
or moderate, or where the sore was in an indolent
state. If the discharges were profuse, the action of
the remedy was much less noticeable, owing, proba-
bly, to the powder having been washed away by the
discharge, and not remaining sufficiently long upon
the wound to produce any marked action upon the
tissues. In these cases I cauterized thoroughly and
unsparingly every point of ulceration at first, and as
soon as the sloughs were removed, powdered them
with the iodoform, and the results were always highly
gratifying.
I have reported these two cases as being typical
ones for the illustration of the action of this remedy.
They are the varieties most commonly met in pri-
vate practice; they heal rapidly under iodoform, and
the unfortunate sufferers need not be tortured with
the painful and destructive cautery. Although
iodoform is principally known to the profession as a
remedy for topical application in venereal diseases,
it has been used by a few for other purposes. We
have seen that it is an excellent remedy for chan-
crous ulcers, and that the indolent variety yields
quickly to its curative action. These curative prop-
erties are supposed to reside in the large propor-
tion of iodine (90 per cent. ) which the drug con-
tains, and in the painlessness, owing to the combi-
nation in which it is held, that attends its applica-
tion.
In the chancrous ulcer we have a variety that runs
a protracted course, and is obstinate to treatment.
In its indolent form it assumes an atonic or torpid
condition, and may be classed under that variety of
ulcers. Here suppuration and disintegration are
2l8
The Medical Union.
prominent, and advance hand in hand in the destruc-
tive process, and but little attempt is made at new
formation.
When these conditions prevail, the surgeon en-
deavors to arrest the disintegration, and cause a
healthy flow of blood to the part, that new forma-
tions may spring up, and that the ulcer may assume
a healthy granulating character. He considers it
absolutely necessary that there should be a free de-
velopment of vessels and stronger cells, which do
not lead to suppuration, but to connective-tissue
new formation. He endeavors to fulfill these indi-
cations by applying caustics or resolvents, that a
state of chronic congestion may be produced in the
ulcer, and that a proper amount of vascularity may
be induced.
Iodine and Nitrate of Silver have been the favor-
ite remedies for topical use in these conditions,
whether venereal or due to other dyscrasise. As
Iodoform works cures in the chancrous variety of
ulcer, so it should in other indolent forms which
arise from dissimilar causes.
As Dr. E. Guernsey and myself believed it not to
be specific for venereal ulcers alone, but to be ap-
plicable in all cases where the topical use of Iodine
might be indicated, we commenced, in the early part
of 1 87 1, a series of investigations with reference to
the value of this remedy in chronic inflammation,
ulcerations, and catarrhal conditions. The follow-
ing marked cases, which are kindly furnished me
by Dr. E. Guernsey, will show the results :
Case I. The action of Iodoform in ulcerative
catarrh was clearly seen in the case of a gentleman
who had complained of it more or less from boy-
hood. He was subject to frequent and severe at-
tacks of hemorrhage from the nose, and scabs were
almost constantly forming along the nasal passage.
The trouble was undoubtedly increased by the con-
stant habit of picking the nose, thus keeping it all
the time irritated. There was no syphilitic taint
whatever in the case, and the patient was apparently
in every other respect strong and in vigorous health.
At the time he came under treatment, the ulceration
had been so severe as to break through the septum,
and the entire nasal passage was in an indolent and
unhealthy condition. Two or three grains of the
pure Iodoform were blown into the nostrils through
a glass tube, thus coming directly in contact with
every part of the diseased surface. The beneficial
effect of the drug was immediately apparent, the
diseased surface rapidly assumed a more healthy
character, and in a short time this trouble, which
had annoyed him for years, was apparently cured.
The following winter, under the influence of the
severe cold, the trouble partially returned, but was
again controlled by the occasional application of the
Iodoform. The smell of the pure drug was so pene-
trating and disagreeable that twenty grains were
combined with half an ounce of Plasma, and this
applied at bed-time with a camel's hair pencil. In
the morning the passage was thoroughly cleansed
with a spray of a weak solution of Muriate of Am-
monia. The result was all that could be desired.
I have repeatedly used the drug in ulcerative ca-
tarrh, and always, when it was indicated, with bene-
ficial results.
Case II. — A little boy about eight years of age
had long suffered with a severe and offensive otor-
rhoea. The ulceration was confined to the external
ear, but was rapidly extending inward, so that at
the time he came under treatment the membrana
tympani was thickened, and his hearing materially
impaired. The ear was cleansed with warm water,
and the Iodoform, combined with Plasma, carefully
applied night and morning. A change was almost
immediately apparent. The discharge in a short
time entirely ceased, and the ear was apparently
cured.
Case III. — A lady who had long suffered from an
unhealthy condition of the meibonean glands, pro-
ducing an ulcerated condition along the edge of the
lid, was speedily relieved by a careful application of
the above remedy night and morning.
In this class of cases, of which those given above
by Dr. E. Guernsey are typical, I have obtained
very gratifying results from its extensive use in dis-
pensary practice.
I have also used it with equally gratifying re-
sults in some forms of uterine derangements.
Erosions, ulcerations, and uterine catarrh are easily
controlled under its application. As illustrative of
its action in the latter disease, I will subjoin the fol-
lowing case :
Mrs. C. was attacked in 1872 with severe uterine
tenesmus, or f ' bearing down pains " whilst riding in
a stage. She returned home as soon as possible,
and I was called in attendance. She was in bed,
suffering with severe uterine pains, which were of
so intense a character that she thought they must
be those of miscarriage. She said that she had en-
joyed very good health until then, excepting that
she had been suffering from a very severe form of
leucorrhcea for two or three weeks previously. At
first the discharge consisted simply of mucus, but
shortly afterwards, became muco-purulent, and in
the last few days was slightly mingled with blood.
For two or three days she had suffered from pains,
weight and dragging in the pelvis, and from consid-
erable vesical and rectal tenesmus.
Upon examination, I found the womb enlarged
and sensitive to the touch, the os uteri gaping and
patulous, and the whole organ lower than normal.
An ocular inspection revealed the cervix swollen,
reddened and inflamed, and a thick creamy, puru-
lent discharge pouring from the pouting os, and a
slight touch of the probe to the uterine canal suf-
ficed to produce a slight flow of blood.
I enjoined absolute quiet in bed, warm applications
over the abdomen, and administered belladonna in-
ternally. In a few days the severity of the attack
was subdued, but the uterine discharge was very
thick and copious, and came away in large clots. I
introduced a suppository of iodoform (each supposi-
tory containing three grains iodoform) into the cervi-
cal canal every third day. After the third application,
the discharge was much thinner and somewhat less
profuse. f!I then combined two grains of tannin,
three of iodoform, with a sufficient quantity of cocoa
butter, in each ] suppository, and introduced them
at the same intervals of time as previously. The
result was most happy, and in a short time the pa-
tient was fully restored to her former good health.
In erosions and ulcerations, I have found it to
be an admirable remedy, supplanting, in a great
measure, the use of the caustic or other irritative
derivatives. I apply it combined with glycerine on a
dossil of lint or cotton, directly in contact with the
morbid part.
Its beneficial effects^in cancer of the uterus have
already been alluded to.
The Medical Union.
219
In gleet it has been used with success in the form
of urethral suppositories, but its persistent odor has
prevented its use becoming generally popular in
these cases.
In bubo, both in the simple and chancrous varie-
ties, its application has been recently highly recom-
mended by Dr. A. A. Izard, of Paris. He advises
its application in the inflammatory or formative
stage, and in the period of ulceration consecutive
to the opening of the abscess.
In the early stage, a thin layer of iodoform oint-
ment (half a drachm of iodoform to an ounce of
lard) is applied over the bubo, and this covered
with an emollient cataplasm. In the suppurative
stage, if the secretion is abundant, injections of
iodoform in glycerine and alcohol are to be made
several times daily; and after the injection, a
pledget of lint soaked in the same solution is to be
introduced into the ulcer. Under its use, the secre-
tion of pus is checked, and then the wound is pow-
dered only with iodoform twice daily.
The great objection to the drug is its pungent,
and, to many, disagreeable smell. This is to a
certain extent removed by its combination with
plasma. The plasma, as prepared by Mr. Wenck,
is made by combining starch with glycerine, in the
following manner, making an elegant preparation
and readily combining with almost any drug :
Formula for plasma-glycerine or glycerate of
starch. — Take wheat starch, two parts; triturate
with distilled water, one part ; add, glycerine, ten
parts. Heat the whole by means of a steam bath
until a translucent homogeneous mass is attained.
THE PRINCIPAL CAUSES OF ERRORS IN
SURGICAL DIAGNOSIS.
By John C. Minor, M. D.
[The following article was originally prepared as one of a
series of lectures on surgery. In its construction, as in that
of the others of the series, the authors of the French school,
and particularly, Gosselin, Guyon, Spillmann, and Legouest,
have been used as authorities.]
I. The information given by the patient may be
incomplete or inexact. It is not always possible to
avoid this source of error. In some cases — strangu-
lated hernia, for instance — the time that has elapsed
since the beginning of the trouble is of the utmost
significance, and the surgeon, in the absence of
characteristic signs, may be easily misled by the
patient. Sometimes the patient purposely deceives
the surgeon in order to obtain an operation which
would be refused if all the facts were known.
Thus, a patient with an old dislocation of years'
standing, being refused an attempt at reduction by
a prudent surgeon, goes to another surgeon, repre-
senting the luxation as one of recent occurrence.
In the examination of solid or fluid tumors the du-
ration of the disease is an important element. In
cases of malingering, when the patient attempts to
deceive the surgeon as to the objective and sub-
jective symptoms, it is a trial of wit and skill on
both sides. A patient was brought into my ward in
one of the army hospitals, during the war, in a piti-
able condition. He had been seized with an epilep-
tic fit in camp, and had come out of -it deaf and
dumb. The only means of communicating with
him was by writing, and the poor fellow implored
me [in writing] to cure him. I attended him with
the utmost solicitude, examining the condition of
his tongue daily, and meantime making some in-
quiries into his case prior to his admittance to the
hospital. I thus learned all the particulars of his
attack, which I cared very little about, and inci-
dentally discovered that he had drawn his bounty
money two days before, which interested me great-
ly. The next morning, after my inquiries were
concluded, while examining his tongue intently, I
was able to cure his deafness instantaneously by
discharging a revolver under his bed. The sudden
explosion was a decided success so far as hearing
was concerned, and I told him that on the next day
I hoped to restore his speech. Accordingly, on
the following morning I had the patient placed
upon the operating table and administered a mix-
ture of chloroform and ether until he passed into
that stage of excitement which precedes complete
anaesthesia. As I expected, he soon began to talk
and shout, and answered all the questions put to
him. I suspended the anaesthetic and kept him
answering questions till the full consciousness of his
recovery dawned upon him and then sent the rascal
back to his regiment as a "bounty-jumper " detect-
ed in malingering.
II. The disease may be observed at a period when
its symptoms are not yet fully pronounced. In a
limited number of surgical diseases the first symp-
toms are purely functional, and in some diseases no
lesion can be found until a later, or chronic period.
Thus the growth of abdominal tumors in the female
has been attended with all the characteristic symp-
toms of pregnancy so as to deceive the most expert
physicians. On the other hand, pregnancy has
been repeatedly diagnosed as a case of ovarian or
other tumor. The only way to avoid this error is
to refrain from a positive diagnosis on a single ex-
amination. Repeated examinations must be made
at suitable times with a view to establish with cer-
tainty the presence or absence of characteristic
symptoms. In metrorrhagia, for instance, an ex-
amination made after the flow may show nothing,
because the orifice of the uterus opens itself during
the hemorrhage and closes itself immediately after-
wards. An examination during the actual period
of the flow may therefore enable us to demonstrate
the presence of a polypus whose existence could
only have been surmised at the first examination.
In Pott's disease, the first stage of the malady is of
long continuance ; its nature is concealed under an
entire absence of symptoms or a few dull pains that
are not characteristic, and its positive diagnosis is
impossible. But the surgeon should always bear in
mind the possibilities of age and constitution in
their bearing upon the case. Pott's disease is a
disease of childhood and is linked with an impaired
constitution by inheritance or by the influence of
bad hygienic conditions and habits. Therefore, if
the possibility of the vertebral affection can be fore-
seen, a point of tenderness developed along the
spine, affected by certain movements, may strength-
en a presumption of the disease, even before the
angular movements, gibbosity, abscesses, and other
characteristic signs appear. In this way the sur-
geon, although still in doubt, may be guided in his
treatment and will not be taken unawares nor com-
promise the confidence reposed in his skill.
III. The examination inay be made at a moment
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when the characteristic symptoms are temporarily
absent. A foreign body gets into the windpipe of a
child. An intense and sudden attack of suffocation
has characterized its lodgment, but the patient has
become perfectly quiet again. If the surgeon, in
making his diagnosis, relies upon the symptoms
observed at this moment, he will certainly be led
into error. If, on a careful inquiry, he finds that
the child has been perfectly well up to the time of
the attack and that this came on sharply and sud-
denly, he should be very cautious. His uncertainty
will cease if another attack occurs or is provoked by
moving the child or by holding it upside down and
patting the back with the palm of the hand. I
know of one case in which what was supposed to be
a severe attack of bronchitis was happily terminated
by the sudden expulsion, in a fit of coughing, of a
clove enclosed in a cystic envelope. The clove had
lodged in the bronchial tube two months previously,
and had given rise to no symptoms until within
three weeks of its expulsion. In strangulated
hernia the surgeon may be misled in his diagnosis
of the condition of the part or of the nature of the
trouble, by the erratic character of the symptoms.
The tumor may be entirely painless from the first
or may become so suddenly; the vomiting may
cease at any time ; all the pain may suddenly be
located in the epigastric region. But in these
cases there are two symptoms that persist — namely,
constipation and the tumor ; and until the absence
of the other symptoms is coincident with the disap-
pearance of these two, there should be no encour-
agement given except in the possibility of relief by
taxis or by operation.
IV. Certain normal or accidental peculiarities of
the region or place where the disease exists may
render a direct examination difficult or impossible.
The boundaries of surgical diagnosis have been
wonderfully enlarged by the application of new
methods of exploration which reveal to our sight
actual lesions as the exciting cause of many symp-
toms that were formerly considered as purely func-
tional. But these instrumental means of diagnosis
are not always harmless in themselves, and in many
cases they are inapplicable or uncertain. Thus,
while the ophthalmoscope may reveal a lesion of the
retina, an opacity of the crystalline lens, as in catar-
act, may prevent the recognition of the lesion. And
when instruments, such as stylets, sounds, &c. , are
used, which compensate for an insufficient length
of the finger, unless the evidence obtained is posi-
tive, they are insufficient for diagnosis: In other
words, an instrumental diagnosis must be an abso-
lute demonstration "beyond the possibility of doubt,
or else it is of no conclusive value. How often,
even in the practice of the most eminent surgeons,
have patients been cut for stone when none existed !
And still more frequently the presence of a stone in
the bladder has been overlooked. And these mis-
takes have occurred after instrumental explorations
of the bladder. It certainly appears that, by the
use of the lithotrite, with which we can measure the
stone, crush it, and even pick up the fragments,
there should be no possibility of committing the
grave error of operating in the absence of stone.
Excessive swelling of a part may present a very
serious obstacle to a diagnosis. After an injury to
the elbow, for instance, the swelling comes on so
rapidly that when the important question arises
whether the case is one of fracture or dislocation, we
may find it not an easy one to decide. In order to
do so it is necessary to make out with precision the
relations of the osseous prominences ; and the rapid
development of swelling and pain seriously inter-
feres with the examination. Malgaigne has pro-
posed to use exploring needles in these cases, and
to make out the diagnosis by thrusting them down
to the bone and thus searching for the prominent
points, but this method is unsatisfactory. The oc-
currence of a phlegmonous inflammation around a
part may preclude any attempt at an examination
for several days. With reference to the pain of an
examination and also in some respects the swelling
which complicates it, we will often find that the use
of chloroform will assist in making an otherwise
difficult matter one of ease and comfort to both
patient and surgeon. This is especially true in
cases of fracture or dislocation.
V. The characteristic symptoms of one disease
may be absent or unrecognized, while those belonging
to another malady are apparent. Under this head
we might enumerate some grave mistakes which
have often led to the most deplorable consequences.
Aneurisms, for instance, have been mistaken for
abscesses and treated as such by free incisions.
Such mistakes have happened to the most cele-
brated surgeons. But the knowledge of their errors
and the possibility of them should make us very
cautious when we find fluctuating tumors located
over the course of the large arteries.
The expansive movement, the thrill and bruit, in
a word, the characteristic symptoms of an aneurism
should be carefully searched for, and if the explora-
tion does not reveal its presence we should not be
in haste to diagnose an abscess. Mere fluctuation
is not, of itself, a sufficient basis on which to found
the diagnosis of an abscess. If acute, the abscess
will have been preceded by an inflammatory period
whose existence can easily be proved. If chronic
or "cold," either in the neighboring parts or in a
more remote region, will be found the lesions which
indicate its origin ; or else the progress of the mala-
dy or the constitution of the patient will clear up
the diagnosis. In these cases, however, we are never
obliged to resort to an immediate operation, and
where there is the slightest doubt, it is prudent to
delay any positive action or opinion till a later
period.
VI. Two different diseases may present similar
symptoms. An abscess may be mistaken for an
aneurism on account of the pulsations communi-
cated to it by a large artery. Such errors are not
rare nor always easy to avoid.
Movements may be communicated to a fluid col-
lection or to a solid tumor, by the heart, the respi-
ration or the brain ; but these may always be dis-
tinguished from those of the aneurismal sac. The
movement communicated by the heart, and by the
arteries as well, has no other effect than to lift up
the tumor at each impulse ; it does not expand it.
The movement communicated by the respiration,
by coughing or sneezing, will coincide with the
thoracic movements. Those transmitted by the
brain will present the double movement which is
characteristic of the encephalic pulsation. The im-
portance of pulsation as a symptom cannot be over-
estimated, and therefore the minutest details of its
occurrence should be noted with care. It should
never be regarded as, of itself, conclusive evidence
of the nature of a tumor, but should always be
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221
interpreted by the aid of all the other symp-
toms.
It may even be difficult to avoid being misled by
so clear and decisive a symptom as fluctuation, and
it has probably happened to every surgeon to pro-
nounce a perfectly solid tumor to be a fluid one.
In this class of errors are recorded the greatest
number of surgical mistakes. It is necessary, then,
to lay down the principle that a doubt is indispensa-
ble whenever an opinion is given. In other words,
the surgeon must remember that the whole category
of solid tumors may offer the phenomenon of fluc-
tuation, either true or false, and that it is of import-
ance, before concluding that liquid is present, to
have other proof than mere fluctuation. As exam-
ples we may cite the frequency with which fatty
tumors have been mistaken for cold abscesses, and
sarcocele of the testicle for hydrocele of the tunica
vaginalis. For the purpose of solving this question
it has been proposed to practise an exploratory
tapping, and when a doubt exists as to whether a
tumor is solid or fluid a resort to this method is le-
gitimate. Where the doubt lies between an abscess
and an aneurism, an exploratory puncture with the
capillary needle of a fine hypodermic syringe is
justifiable.
VII. Two diseases may coexist, and the symp-
toms of one may mask those of another, prevent its
recognition, or alter its appearance so as to embar-
rass the surgeon. One disease may be so promi-
nent in its features that the other may be overlooked.
It may be that an examination is impossible. For
instance, an atresia of the pupil with adhesions may
prevent any examination of the crystalline lens or the
interior of the eye, both of which may be in a diseased
condition. We may indeed appreciate the condition
of the retina by a study of the functional symptoms,
but this is not the case with the crystalline lens.
Therefore, there will be a doubt, in such a case,
whether an excision of the iris will permit the rays
of light to penetrate the crystalline lens and reach
the interior of the eye. Much graver examples,
however, may be instanced. An abscess may de-
velop upon or around an aneurism; this is opened,
and when the pus has escaped, the aneurism, which
had been merely plugged by a clot, gives issue to an
arterial hemorrhage. Such is the case quoted by
Scarpa, as occurring in the practice of Volpi. The
patient had been treated by compression for a false
aneurism occurring in the bend of the arm, and had
left the hospital almost completely cured. A blow
from a stick, received some time afterward, resulted
in the formation of an abscess, the opening of which
was followed by such profuse hemorrhage as to ne-
cessitate amputation.
Peritonitis may attack a patient who has for a
long time had an irreducible hernia. The history
of the case should give a clue to its solution, and an
examination of the tumor may confirm our diag-
nosis, for it will not present the usual tense condi-
tion that we observe in strangulation. But above
all we may assure ourselves of the permeability of
the intestine by administering a purgative. In one
case this method failed in my hands. The patient,
suffering from inguinal hernia of the right side, was
attacked with symptoms of strangulation. He had
peritoneal pain and symptoms of inflammation, with
stercoraceous vomiting and obstinate constipation,
which purgatives did not affect. The hernia was a
reducible one, and was restored by taxis by a sur-
geon in Albany, but without any relief. The intes-
tine soon came down again, and on the fourth day
of the attack he arived in this city, presenting all
the symptoms of a marked case of strangulation, for
at this period the hernia was no longer reducible. In
the presence of Drs. Blumenthal and Throop, I
performed the operation of herniotomy, and found
some adhesions which rendered the hernia irreduc-
ible, but there was no strangulation. He finally
recovered, the condition lasting till the twenty-
fourth day, when the persistent use of large injec-
tions was followed by an immense evacuation, and
the gradual subsidence of all the symptoms. The
case was a remarkable one, and I believe an accur-
ate diagnosis to have been impossible.
In very extensive and severe injuries, a lesion
may escape notice because the patient's condition is
such that a complete examination is impossible, or
because the examination has not been made with
sufficient care, the surgeon's attention being ab-
sorbed by the more prominent lesions.
Felix Guyon relates the following case (Chirur-
gie Clinique, p. 140) : "I was once called to at-
tend a coachman who was thrown violently from his
box. His lip, nose, and right eye were deeply cut,
and his skull fractured. The gravity of these wounds,
especially of the last one, and the insensible conditi m
of the patient combined to make me overlook for
several days a fracture of his left clavicle." The
coexistence of two diseases may lead the surgeon
into error, but there are certain diseases in which
we must suspect more than at first appears. For
instance, the relation between albuminuria and dis-
eases of the interior of the eye should be borne in
mind. In like manner, the occurrence of carbuncle
or gangrene should lead the surgeon to examine the
urine at once for traces of sugar, and he should also
remember that, in the female, erythema and pruritus
of the vulva are among the earliest manifestations
of glycosuria. It is by attention to little things
that we appreciate more important ones, and
when we base a diagnosis on the totality of the
symptoms, no symptom is to be considered a trivial
one.
VIII. The nature of the disease may be under-
stood, and the diagnosis still remain incomplete.
The shoulder may be evidently dislocated, but what
variety of dislocation is present may not be so clear.
The leg may be fractured, but what is the direction
of the fragments ? These are questions which the
surgeon must invariably attempt to solve, if he wishes
to make a really practical and scientific diagnosis.
And yet the welfare of the patient or the difficulties
of the case may compel us to hesitate. We may
often diagnose a fracture of the ribs with sufficient
accuracy without finding or seeking for the charac-
teristic crepitation of the particular rib involved,
and it is unnecessary in such cases to subject the
patient to the pain of an examination.
The location and nature of a tumor may be ac-
curately known, but its adhesions may be unre-
vealed until the time of operation. In three cases I
removed the upper jaw for a disease — encephaloid
cancer — which originated in the ethmoid bone, be-
yond the reach of any operation. [The result of
these cases, and an examination of the literature on
the subject, leads me to question whether encepha-
loid cancer ever originates in the superior maxillary
bones. The weight of evidence points decidedly to
the ethmoid bone as the primary location of many
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tumors that are diagnosed as developing in the an-
trum.]
With reference to the bearing of a complete diag-
nosis upon operative measures, only a very few ope-
rations are performed with a certain and exact fore-
knowledge of all the circumstances of the lesion. In
the large majority of operations, unexpected dan-
gers and difficulties arise which are beyond our
powers of prevision. It is the meeting of these
emergencies with promptitude, coolness, dexterity,
and sound judgment that determines the quality of
the surgeon. Nothing should be done on the in-
spiration of the moment. Inspiration is not desir-
able as one of the qualifications of a surgeon. The
only sure basis for brilliant results lies in patient,
thoughtful study, and in the power of condensing
years of such study into practical shape in a critical
moment.
A NEW METHOD OF TREATMENT FOR THE
CURE OF PROLAPSUS UTERI.
By Dr. Payr, of Passau.
Neue Zeitschrift fiir Homceopathische Klinik.
Translated by William N. Guernsey, M.D.
The third and fourth numbers of the forty-fifth
volume of Virchow's Archives of Pathological Anat-
omy, Physiology and Clinical Medicine, contain
under the title of " Cases of the Cure of Pro-
lapsus Uteri Without Mechanical Means by Dr.
Nicolai Andreef," an article upon the method of
treatment of prolapsus of the uterus as is pursued
in the gynecological ward of Prof. Kosloff. As it
seems to us 'well worthy of notice, we believe that
we should not withhold it from those of our pro-
fessional brethren who may not have Virchow's
Archives at hand.
Andreef says that he has made the observation
that an alcoholic solution of iodine possesses the
properties of toning up the relaxed and weakened
uterine ligaments, and has the power of restoring
them more or less to their normal condition. This
observation led him to test the action of this prepa-
ration of iodine upon the descent and prolapse of
the womb, and as his experiments procured such
gratifying results, he could not forbear communi-
cating them to the German physicians, recommend-
ing them to their gracious attention.
In August, 1 87 1, continues the writer in his re-
port, I became acquainted with a patient who had
suffered for four years with complete prolapsus of
the uterus. She had sought relief for her misfor-
tune in the various methods of cure by mechanical
means, without having found any alleviation.
She was twenty-two years old, slender, and of a
frail frame, and four years ago was attacked, im-
mediately after her confinement, with a falling of
the womb, which afterwards became a complete
prolapsus. The procidentia was so entire, the re-
laxation of the tissues of such a high degree, that a
severe cough sufficed after its replacement to throw
it out beyond the labia.
The treatment consisted in the reposition of the
womb in a horizontal position, and upon introduc-
tion of the speculum, in the penciling of the vagi-
nal walls which surrounded the cervix with a half
drachm of diluted tincture of iodine (Tinct. Iodini,
Alcohol rectif. ana part, aequal.). The undiluted
iodine produces frequently an acute catarrh of the
vagina and of the uterus, according to the writer's
experience, which disappears spontaneously never-
theless, as a previously treated case showed, without
thwarting the desired end.
After the application, the patient remained in a
comfortable horizontal position, and received four
times daily a vaginal douche of well water, at the
temperature of 200 R. This treatment with the
diluted Iodine was repeated every third day, the
strength of the solution being increased at each ap-
plication, and after the fourth one the patient was
restored.
The womb did not undergo any prolapse during
the succeeding four months, and the patient is now
enciente, and in perfect health.
It was afterwards my fortune to completely cure
by this method two cases of partial prolapse, and
five of complete procidentia, of long standing.
The author does not wish to tire the reader with a
description of all these cases, yet would detail more
fully a case of complete procidentia uteri, which
was committed to his care by Prof. Kosloff, and
which we heartily approve, that the reader may
learn to know and appreciate the complications
which may arise during the course of the treatment.
Maria Gabrilova, a soldier's wife, aged fifty, of
medium stature, entered the gynecological ward on
the 20th of September of last year, and complained
of a complete procidentia of the uterus, which had
formed five months previously upon a partial pro-
lapse, which had occurred a long time before.
She had given birth to her only child thirty years
since, and twenty-nine years ago miscarried in the
seventh month of her pregnancy, in consequence of
lifting heavy weights. The menses had disappeared
ten years since.
An examination revealed a body of oval form sus-
pended between the labia externa, the broad end of
which was at the pudendal opening, and the smaller
one lay below. The body measured 2>£ inches in
length, its greatest width was 1 % inches, and the
smallest at the free end was one inch. Situated upon
the small end was a transverse fissure, surrounded
by swollen red edges, upon which were erosions.
Into this fissure the end of the forefinger could
easily penetrate. The entire body had a pale rose-
red color, was destitute of moisture, and showed
folds upon its upper surface, which ran parallel with
the external genital opening. These disappeared
upon the smaller end of the body, and had the ap-
pearance as if they belonged to a sack in which the
protruded body was situated, as they could be easily
moved underneath it. The end of the body where
the fissure was situated was inclined somewhat back-
wards. A slight compression of the prolapsus
caused it to recede into the pelvic cavity. The
patient stated that she was generally able to reduce
the tumor, but walking a few steps always pro-
lapsed it again.
As there was scarcely any disease of the vagina
present, the uterus was replaced, and, putting the
patient in a horizontal position, with the aid of the
speculum, the vaginal arch was penciled with the
Iodine solution. A half hour afterwards the patient
received a vaginal douche of water, at 180 R., which
was repeated four times daily. The douches have
the purpose of diminishing the pain and heat in the
vagina, which often attains quite a high degree.
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223
The quantity of the Iodine used was a-half drachm,
and that intense reactionary symptoms may be pre-
vented, a larger quantity should never be used at
the first application. The patient retained the hori-
zontal position, and used the vaginal douch, with
the above-mentioned frequency, for three days.
Twelve hours after the first application, the uterus
stood % inch below its normal position ; the vagina
was dry, somewhat hardened, and inflamed, and
there was no secretion from the uterus to be noticed.
September 23. — The vagina moister; the uterus
occupies the same position ; the temperature of the
vagina is fallen, although yet higher than normal.
September 26. — The uterus does not fall when
the patient assumes an upright position. The va-
gina is soft and relaxed, and as there is no secretion,
a second application of Iodine is made, the strength
of the mixture being increased so that there is only
one part of Alcohol to three of Iodine. At this
penciling a drachm of the strong solution is ap-
plied.
Twelve hours after the second application the
uterus occupied the normal position. The same
symptoms manifested themselves in the vagina as
after the first application, but only in a lighter de-
gree. The vaginal douche is applied once daily with
water at 209 R.
October 4. — Pains at the scrobiculus cordis and
in both hypochondriac regions have set in, as has
also a severe cough. The usual remedies were pre-
scribed for these symptoms.
October 9. — The uterus occupies its normal
position. The vagina secretes somewhat more
mucus than ordinarily, but otherwise shows no ab-
normal symptoms.
October 15. — The position of the uterus has re-
mained the same. From this time the cold douche
was discontinued.
October 27. — The patient coughs and has pain
in the epigastrium, and in both hypochondriac re-
gions. Vomiting occurs even after taking very
small quantities of food. She has no appetite, and
suffers with sleeplessness.
October 30. — The vomiting has ceased, the ap-
petite and sleep have come back again, but the
cough still remains. The uterus is in its normal
position.
November 4 — The cough and the pains in the scro-
biculus cordis and in the hypochondria have nearly
ceased under the administration of tinct. valer.,
ether, and the use of warm baths.
November 5. — There are only slight pains re-
maining in the chest and back. The uterus re-
tains its normal position.
Up to November 20, all the symptoms of dis-
ease have disappeared. Already the patient, for the
past fourteen days, has assisted the nurses in their
work, and the lifting of burdens which were very
heavy for one of her age and strength has produced
no relapse.
In this case two applications were sufficient for a
complete cure ; ordinarily, more are necessary, but
the number has never exceeded six.
From this case, as well as others, I have drawn
the conclusion that the best result is to be attained
by the observance of the following conditions :
a. It must be possible to replace the uterus.
b. Before one proceeds to the employment of the
method described above, all other diseases of the
vagina and of the uterus, e. g., erosions, ulcers, etc.,
must be relieved as far as possible, as inflammatory
symptoms may easily occur.
c. Only the vaginal arch is to be painted, and
at first with the diluted, and later on with a more
concentrated solution. In connection, the cold vagi-
nal douches are indispensable for the prevention
of severe reaction.
d. In the majority of cases the patient need not
be required to rigorously retain the horizontal posi-
tion after the second application. After a week
and a-half s treatment she may be allowed to walk
and do light work.
e. The bowels must be kept open so far as possi-
ble.
f. The interval between the applications should
not be less than three days, that the irritation may
not necessarily be increased. After the completion
of the treatment with the iodine solution, the vagi-
nal douches with water at 20? R. are to be con-
tinued for some time.
After the completion of the cure, the vagina is
neither noticeably smaller nor thicker than previ-
ously.
Frequently, after the replacement of the uterus,
sympathetic disturbances arise, but they are easily
and quickly relieved.
Although we cannot say that we agree with the
writer in his view that the topical application
of the iodine produces a tonic action upon the
ligamentous structures of the uterus, as we are
more of the opinion that the fixation of the uterus
following the toxic use of the iodine is to be re-
garded rather as due to the retraction established
by the irritation, and as the result of an actual
adhesive inflammation. Nevertheless, AndreefPs
method of treatment merits the full attention of
every gynecologist.
When one considers the annoying symptoms co-
incident to prolapsus uteri, the burdensome feeling
of dragging and tension in the hypogastric, and
especially in the lumbar regions, the pressure in the
vagina upon the bladder and the rectum, the de-
rangement of the functions of these organs, the
strangury and constipation, the lassitude in the
limbs, the exhaustion of the physical strength, and
the concomitant depression of the spirits of these
patients, one can scarcely expect much relief from
the mechanical character of these symptoms, es-
pecially in those whose circumstances in life are
such that they are subject to severe hard work, from
any dynamic action of Belladonna, Nux- Vomica,
Sepia or Secale. We, at least, have often used these
remedies for months without attaining any satis-
factory results.
Also, there are a large number of unfortunate
patients afflicted with this infirmity who can not en-
dure the pressure and irritation of the pessary or
uterine supporters, and are consequently deprived
of these palliatives. In these cases the physician is
in a completely helpless position and must abandon
them hopelessly to their sad fate.
Yet I hear from another side that medical aid is
not yet powerless in these cases, and that they are all
amenable to treatment. Is, then, of no avail the
operation of Episiororhaphy, which was devised by
Fricke and successfully performed by Dieffenbach,
Koch and others ? an operation which in some cases
has not even made coition and parturition impossi-
ble. If medical skill is of no avail, of what purpose,
then, the operation of Elytrorrhaphy as performed
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by Dieffenbach, or, the application of the actual
cautery ?
There is no doubt but that every patient will de-
cide for the mildest and simplest operation in pre-
ference to the bloodier ones, if it offers to her the
same if not a better prospect of success. This
method in cases where internal medication has been
fruitless, promises relief by a very simple and the
most harmless manner of treatment, and with the
avoidance of all injurious results which are liable to
eventually destroy sexual life.
DIAGNOSIS OF CANCER.
By A. Varona, M. D.
Visiting Surgeon Brooklyn Homoeopathic Hospital, Attending
Surgeon to the Brooklyn Maternity, Etc.
"If ever you are at a loss to diagnosticate a case
of protracted illness for lack of tangible symptoms,
call it nervous. Again, if you see a patient slowly
but inevitably approaching dissolution, and know
not how to account for the fatal phenomenon, no
matter what the symptoms may be — for they are all
admissible — call it cancer. In the first instance, no
one will wonder that the case lingers; in the second,
no one will blame if the patient dies, and in both
your omniscience will be established." Thus spoke
Nelaton, in December, 1859, as we walked through
one of the wards of L'hopital Necker, discours-
ing upon an obscure case of internal disease which
some physicians had pronounced decidedly cancer-
ous.
Bearing these words in mind, I have often won-
dered which of the two it is that has so prodigiously
multiplied, of late, cases of internal malignant dis-
ease, or followers of Nelaton's sarcastic advice ?
If the former, the facility with which they are de-
tected and mathematically classified, leaves me to
think the resources of science afford to others sub-
tleties of diagnosis which are refused to me ; if the
latter, we cannot close our eyes to the fact that the
utilitarian atmosphere which overhangs the business
world has sadly invaded the pure realm of the medi-
cal profession.
Cancer, at best, when developed upon parts and
tissues exposed to our view, subject to the direct
investigation of our senses — sight, touch, smell, — li-
able to the minute test of chemical and microscopi-
cal analysis, is a disease of difficult diagnosis.
No one case is ever so definitely and unequivocally
established but that; subjected to the independent
and unbiased appreciation of different individuals,
there would be marked and, perhaps, radical dis-
crepancies.
In no one of its numerous forms does it reveal
itself so plainly as to preclude the possibility of an
error.
According to the avowed opinion of theorists,
whose uncertainties, however great, are always short
of what we find in practice, "The diagnosis of the
different forms of cancer is not always easily made. "
Scirrhus may easily be confounded with divers
fibromata, with various glandular enlargements,
with indurated atrophy of certain parts, etc.
Encephaloid tumors are often difficult to differ-
entiate from some species of abscess, from cystic,
fatty, erectile and non-palpitating sanguineous tu-
mors.
The melanotic form can be mistaken for incipient
leprous tumors.
The epithelial cancer is sometimes difficult to dis-
tinguish from certain ulcers — and the fungoid from
sprouting intracystic growths and other excrescences
and fungi.
Chemical and microscopical tests are, on the
other hand, unreliable in the extreme.
The cancer juice would be indeed a characteristic
fluid did not the human body yield other juices
physically and chemically analogous to it. The
cancer cells would furnish a sure diagnostic feature,
were there not a thousand and one forms of them,
and one and a thousand other cells precisely like
them.
In fine, the cancerous cachexia, which seems to
be the decisive evidence with many, is precisely the
least significant of them all ; for while cancer may
exist with or without it, a state similar to the pecu-
liar appearance to which that name has been given
may exist in the absence of cancer. The excessive
pallor is simply symptomatic of anaemia; the
leaden hue is merely due to poisoning of the blood
from any toxical cause ; the pinched features to
starvation of the tissues ; the acid breath, watery
eructations and black vomit to gastric derangement
attending many adynamic conditions of the system.
Moreover, in all diseases where malformation and
destruction of tissue is a prominent feature, or
where a virulent infection is suspected, the adepts of
the old system, who are as yet the more numerous,
use three remedial agents (in days past, in doses
which have astonished the present, in the present
day in doses that will astonish the future), mercu-
rials, iodides and arsenitesj the effects of which are,
in some instances (where the remedy and the dis-
ease hold the due relation of similarity to each
other), to effectively cure the malady ; but mothers
(the number of which is by far greater than gene-
rally supposed) simply to add to the existing ail-
ment, by reason of the toxical effect of these power-
ful poisons, a condition of the system in all points
resembling the so-called cachexia ; hence its appear-
ance in many diseases, cancerous and not cancerous,
after prolonged irrational treatment.
Let us add that abstinence, sometimes abused as
a means of cure, at other times the natural result of
certain pathological conditions, which entirely de-
stroy the chymifying powers of the stomach, will
produce the same cachectic appearance, and we shall
have disposed of this unreliable evidence, and left
cancer, what it is, a pathological enigma.
And if it be such when developing itself under our
very grasp, how much the more difficult — nay, im-
possible, even — the correct appreciation of this'mor-
bid phenomena in the occult regions of the viscera ;
yet how accurately, how definitely, how unappeal-
ably, and, saddest of all, how frequently this terrible
sentence is pronounced upon an unfortunate being,
" Cancer of the stomach ! " Wonderful powers of
clairvoyance, how I do envy them ! I will illustrate
the subject with but two very recent examples.
In the early part of the present year, Miss H.,
aged thirty-two, left the Brooklyn City Hospital,
where a sapient jury of regulars had found her
guilty of cancer of the stomach, and condemned her
to inevitable death in sixty days. She applied to
the Brooklyn Homoeopathic Hospital for a bed
The Medical Union.
225
wherein to await the fulfillment of the fatal augury.
The bed was granted, and, with all due respect for
the augurers, the patient placed under the care of
Dr. Whitney, of the hospital board. In sixty days,
precisely the time counted upon by the prophets,
the lady was well and about. Was it a case of can-
cer cured by the one, or an error of diagnosis made
by the others ?
On or about the middle of April of the present
year, I was called in consultation in the case of a
lady suffering, according to the opinion of some of
the most noted old practitioners of both New York
and Brooklyn, from a soit-disant cancer, which
they located, first in the pylorus, then " somewhere
under the liver," and lastly in the caput coli. The
gentleman who consulted me did not, in spite of the
altisonant names of the diagnosticians, coincide with
their views, and as for myself, I never could discover
any traces of cancer in the stomach, liver, or colon.
I thought I detected, in the midst of an enormous
amount of ascitic fluid, the presence of cystic tumors
of the ovaries ; this, however, I could not fully as-
certain when first called, as the gentlest palpitation
caused excruciating pains, which it would have been
inhuman to inflict, now that the end was fast approach-
ing. I became quite confident of it, however, im-
mediately after death, and when called upon to give
my certificate I wrote, in simple faith, "Death,
caused by cysto-sarcomatous tumor of the ovaries."
The joy with which this written evidence of supine
ignorance was received at old-school head-quarters
can readily be conjectured, and how they deter-
mined to expose the presuming ignoramus is easily
explained by what follows.
My certificate had not been many hours before
the Board of Health when I received a visit from
Dr. X (not wishing to be at all personal, I have
not used the correct initial), one of the old practi-
tioners formerly interested in the case. Not being
honored with Dr. X's acquaintance, I had to wait
until he had introduced himself, and when he had
done so, though my surprise was as great as my
pleasure, I did my gentlemanly best to make him
feel comfortably and at home, but to no avail, for
he showed in every line of his features that only the
immense amount of future gratification which he
was promising himself would ever compensate for
the torture he was enduring at being obliged to call,
in a professional capacity, on a miserable apostate.
He had, it appeared, asked of the family of the
deceased to be allowed to hold a post-mortem ex-
amination, that he might establish the correctness
of his own and his associates' views ; the family had
refused to do so, unless I consented, and he (deter-
mined not to lose this opportunity of crushing at
least two excommunicants) did not shrink from call-
ing personally to solicit my consent, which I, of
course, instantly and joyfully granted, then saw
him to the door with undiluted marks of attention,
for which I received not an infinitesimal sign of re-
cognition.
The next morning had been fixed upon for the
event, and I punctually attended. My colleague,
though having been a longer time in connection with
the case than any one, had not been invited by Dr.
X, but his own sect had been summoned, in the
person of several of its most noted personages, to wit-
ness the triumph; as for myself, having nothing to
fear, nothing to boast of, I had gone alone.
My arrival, however unnoticed, was the signal for
the beginning of hostilities. Dr. X opened fire on
me from the other side of the cadaver, by asking
me, in the most incisively sweet tone : "What did
you say, sir, was your opinion of the case ? " "My
opinion, sir," said I, in the meekest possible tone,
and scarcely daring to raise my eyes, " is that we
shall find here cysto-sarcomatous growths involving
the ovaries ; yet I advance this opinion with all due
reserve — I may be mistaken." "Well," said he,
looking up with a smile of profound commiseration,
"this case, gentlemen, came under my charge
some years ago ; I then diagnosticated a cancer situ-
ated about the caput coli, and my friend, Dr. W.
P., of New York, fully corroborated my opinion; I
have had no reason to change it since, and in fact /
can now feel the growth under my hand," and say-
ing this he grasped a fold of integument directly
under the region of the liver. " Will you proceed,
Doctor," he added, beckoning to a professor he had
brought expressly for the operation.
The gentleman began by making a tegumentary
incision along the linea-alba, from the ensiform car-
tilage to the pubis, then a deeper one through the
muscular fibres down to the peritoneum, and lastly,
one through this membrane. No sooner had this
incision reached the lower part of the abdomen than
up sprang, from the left iliac cavity, a huge tumor
the size of a fcetal head at term. " What is that ?"
exclaimed Dr. X, springing back as if he had seen a
ghost. " That," said I, in the same meek tone in
which I had before spoken, " that is a cysto-sarcom-
atous tumor of the left ovary. If you will now
look into the right side," I added, addressing the
operator, "you will probably find another one of
the same nature." And so he did, to the intense
disappointment of Dr. X, who looked the very per-
sonification of blank despondency. "Search up
above," he said, at last rousing himself into action;
"examine the intestines, the liver, the stomach."
And everything was examined, and cut and slashed
in the most unnecessary manner, but the mythical
cancer was nowhere to be found.
I could cite many other cases where like errors
have been committed in attempting to define and
locate internal malignant disease, but the above will
suffice for my purpose — viz., to prove that in the
present primitive state of the medical sciences, a
physician is not always able to trace a clear diag-
nosis of visible, and seldom, if ever, of invisible can-
cer.
The frequent incorrect classification to which I
have alluded are sometimes due to honest ignorance,
and constitute bona-fide errors ; but the worst feature
of these cases is that they are often deliberate
deceptions, practised either through conceit or a
false sense of duty : that is, some will rather give
any name to a disease (and in that case they con-
sider the worst the best) than confess that there ex-
ists a limit to their knowledge ; while others have
the mistaken idea that something must be said to
satisfy the patient and friends.
The consequences of such procedure are doubly
fatal.
Firstly, by thus expressing a decided opinion
upon a subject really undecided in his mind, the
practitioner who begins by endeavoring to convince
others of what he then knows to be false, gradually
ends by bringing about a tacit conviction in him-
self, which checks his investigating powers, misleads
his practice, and makes his art a farce.
226
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Secondly, the hopelessness involved in the diag-
nosis deprives the practitioner of the benefit of one
of the most powerful therapeutical agents known
(alas ! unknown to many), the emotional force by
which the co-operation of mental, volitional, and
other nervous impulses is secured and made to op-
erate as curative elements.
In conclusion, I will go still further. In cases of
clear, unmistakable malignancy, considering the
poverty of our medicinal means of combating them,
can we afford to loose the help of this last-mentioned
panacea, the mind ? And is it not lost, irretrievably
lost, by the sole utterance of this one horrid word,
cancer ?
SYPHILITIC LARYNGITIS.
By E. J. Whitney, M. D.
Laryngeal affections resulting from syphilitic ab-
sorption are by no means uncommon, and their
character and appearance depend mainly upon the
period of the disease at which they arise, and also
upon the general condition and health of the patient.
The diseased action may or may not be accom-
panied by dyspnoea, but there is nearly always
danger of its occurrence from thickening or infiltra-
tion of the parts, from separated portions of ne-
crosed cartilage, or from spasm produced by irrita-
tion ; one should, therefore, be ever watchful of
this dangerous and often fatal complication.
Impairment of the voice is seldom absent, and
may be indicated by complete aphonia, hoarseness,
and roughness of the tone, or alteration in any of the
intermediate degrees, which, although easily recog-
nized, cannot readily be described.
The degree of aphonia or hoarseness does not
necessarily depend upon the amount of diseased
action, nor does it afford any certain idea of the
extent of the destructive process, inasmuch as a
small condyloma upon the inner edge of either vocal
cord, or thickening or loss of substance of its invest-
ing membrane, may give rise to aphonia as com-
plete as though the destruction of the cords had
been accomplished, or the cartilages displaced.
Swallowing of either solids or liquids is usually
attended with pain, the latter more than the for-
mer, from their proneness to "go the wrong way,"
and give rise to sensations of impending suffocation.
The course of the disease varies greatly, at times
yielding promptly to remedial measures, and again
spreading rapidly and destructively in spite of every
effort to stay its course ; but even under the most
favorable circumstances, the voice nearly always re-
mains permanently altered, and attacks of acute
laryngitis are liable to arise from cold or other
simple exciting causes not unfrequently attended
with great distress in breathing. In tertiary syphi-
litic ulcerations the epiglottis is most frequently
first affected ; following in frequency and order of
attack are the vocal cords and laryngeal cavity.
The ary-epiglottic folds are rarely invaded by this
form of ulceration, while the anterior aspect of the
laryngeal cavity is more favorable to its action than
the posterior.
Ulceration, so characteristic of this disease, and
developed as one of its earliest symptoms, is rapid
and destructive in its course. The ulcers, deep and
irregular in form, with borders raised from infiltra-
tion, are covered with a dirty yellowish or grayish se-
cretion, revealing upon removal a hyperaemic base,
which readily bleeds.
The activity of this process causes considerable
surrounding tumefaction, which, however, is a
sequel to the ulcerative process, and rarely precedes
it. Chondritis or peri-chondritis may accompany
or succeed ulceration, and a sequestrum of cartilage,
becoming engaged in the air passages, may pro-
duce asphyxia from its presence as a foreign body.
The ravages of this dread disease still progressing
and invading the deeper structures, blood-vessels
may be opened, and hemorrhage produced, which
may suddenly prove fatal.
Cicatrization, which follows the subsiding ulcera-
tion, affords distinctive characteristics no less
marked and important than those of the ulcerative
stage itself. There exists a marked tendency in
this form of inflammation to deposition of fibrine,
which sooner or later becomes organized tissue;
permanent adhesions and contraction of the walls
of the larynx are thus established, its calibre being
thereby lessened to such a degree that more or less
dyspnoea is constantly observed. In these cases
tracheotomy must often be resorted to as the only
means of saving the life of the unhappy sufferer.
The cicatrix consists of radiating fibrous bands,
firm and tense in their organization, giving to the
part, a " puckered," contracted appearance, which
is unmistakable. These cicatrices, according to
Tobold, Semeleder, and other writers, are often
covered with abundant papillary growths, which
may be either sessile or projecting; these neo-
plasms, which are small, have a grayish- white color,
and are most readily found on the posterior portion
of the vocal cords and ventricular bands. The
co-existence of condylomata with the process of
active ulceration is seldom or never seen, for it is
only after the diseased action has spent itself, at
any given point, and cicatrization has become
established, that these growths are to be found
upon the newly restored surface.
Still, syphilitic neoplasms may make their ap-
pearance within the laryngeal cavity without any
preceding ulceration, and their position and char-
acter readily observed by the laryngoscope.
Most writers affirm the absence of any character-
istic features in this form of ulceration. It is true
that so far as symptoms alone are concerned, no
positive or exclusive diagnosis can be arrived at,
but the laryngoscope affords ready means, in the
great majority of cases, for a correct opinion.
There are two other morbid conditions of the
larynx which are most liable to be confounded with
syphilitic laryngitis, the symptoms of which do not
afford distinctive differentia, ist. Chronic Laryn-
gitis; 2nd Laryngeal Phthisis. The latter is not
unfrequently found coexisting with syphilitic laryn-
gitis, rendering a diagnosis by subjective signs
alone a matter of extreme difficulty ; but the laryn-
geal mirror, reflecting the morbid processes, clearly
and unerringly defines the characteristic appear-
ances, which, by the practiced eye, are quickly re-
cognized.
What, then, are those morbid " landmarks" which
differentiate between these morbid conditions ? The
symptoms and anatomico-pathological changes
pertaining to Laryngitis Syphilitica, Laryngitis
Chronica, and Phthisical Laryngitis, as noted below,
The Medical Union
227
will be found of importance in obtaining a correct
diagnosis in doubtful or " mixed " cases.
Appearance of the parts as seen in the laryn-
geal mirror :
SYPHILITIC LARYN-
GITIS.
Epiglottis generally the part
first attacked. Ulceration de-
veloped early. Rapid, destruc-
tive, and deep. Swelling follows
ulceration. Color of the parts
deep red or purple ; secretion
thick, and of a yellowish or
gray color. Condylomata dis-
tributed over cicatrices. Parts
not especially sensitive to
touch.
LARYNGEAL PHTHISIS,
Seat of disease (generally),
Ary-epiglottic folds. Parts
from the first tumid and puffy,
with but little tendency to ul-
cerate. Ulcerations very shal-
low ; discharge thin and
glahy. Color pale and ancemic.
Swelling always precedes ulcer-
ation. Excessive hypercesthe-
sia of the parts.
CHRONIC LARYNGITIS.
Vocal cords and ventricular
bands most subject to diseased
action. Color bright red, ul-
cerations shallow and of slow
progress.
SUBJECTIVE SYMPTOMS.
SYPHILITIC LARYN-
GITIS.
Painful deglutition. Solids
swallowed more easily than
liquids. Aphonia or hoarse-
ness, usually no cough. Res-
piration sometimes embar-
rassed.
LARYNGEAL PHTHISIS.
Pain in swallowing. Voice
aphonic or dysphonic. Near-
ly always cough. Often dysp-
noea.
CHRONIC LARYNGITIS.
No pain in swallowing, no
cough. Aphonia or huskiness
of the voice. No difficulty of
respiration.
From a summary of the foregoing, it will be
noticed that morbid changes, as reflected in the
laryngeal mirror, afford positive means of diagno-
sis, while subjective symptoms are not wholly to
be relied upon. The previous history of the patient,
together with the traces of diseased action in the
fauces, might be considered as conclusive evidence,
but in many the faucial signs may be wanting, or
the previous history obscure, while in others the
taint may be solely hereditary.
Therapeutical indications are to be found in the
symptoms presented in each case, and no prescribed
line of treatment can be suggested for all, except
that constitutional remedies are to be most relied
upon, although local measures are by no means to
be despised. These remedies are to be found chiefly
among those whose action is anti-syphilitic, among
which, and ranking foremost, are the mercurials.
Aurum Foliat. — Caries of the mastoid process and
bones of the nose or palate, suffocative attacks, pain
in the bones at night.
Iodine. — Hoarseness, with tickling and tingling
in the larynx. Pain in the bones worse at night.
Kali Bichrom. — Sensation, as from ulceration of
the larynx; hoarse, rough voice, fauces of a dark
red or coppery color ; deep excavated sore, containing
yellow tenacious mucus at the base of uvula.
Throat pains when the tongue is protruded.
Kali Carb. — Difficult deglutition; the food gets
easily into the windpipe. Hoarseness, with sneez-
ing.
Kali Hydriod is better given in appreciable doses.
Lycopodium. — Carious Nodosities.
Mercurius Corros. — Phagedenic ulcers of the
throat; hoarseness, aphonia.
Mercurius Vivus. — Syphilitic ulcers of the mouth
and throat ; stinging and burning pain in the throat,
aggravated by empty deglutition ; hoarseness and
tickling in the larynx.
Nitric Acid. — Great soreness of the bones of the
skull, stinging in the larynx, hoarseness, sycotic con-
dylomata ; painfulness of the bones worse at night.
Phosphorus. — Hoarseness, aphonia, great pain-
fulness of the larynx ; dryness, soreness, and rough-
ness of the larynx.
Phytolacca Decandra. — Dryness in the throat,
with sycotic rheumatism.
Local applications to the diseased parts, either
with the brush or by atomized or vaporized inhala-
tions, often prove of great service as adjuvants to
constitutional treatment. Argentum nit. may
be used to stimulate cicatrization in indolent ulcera-
tions, or to stay the progress of the more active and
destructive variety. When indicated — and great care
and judgment should be exercised in its use — the
solid substance is preferable to solutions, as the
latter more readily excite spasm of the glottis.
Acid Nitrate of Mercury, Cuprum Sulphat, Sol.
Lugol, Carbolic Acid, in solutions of the required
strength, will prove more or less serviceable.
Among the inhalations and vapors may be men-
tioned, Acidi Acetici, Acidi Benzoici, Acidi Carbol-
ci, Vapor Creosoti, Iodii, Iodoformi, and Thymolis.
100 Lafayette Avenue, Brooklyn, N. Y.
Tobacco Poisoning. — A German, age 43 years,
with intent to destroy life, took 15 drops of the oil
of tobacco. This was taken on an empty stomach.
I was called, and saw him in ten minutes or less
after he had taken it. Upon entering the room, I
noticed two short inspirations, and all was ended.
From the statements of the family, he had convul-
sions immediately after drinking the poison, and
sank to the floor. I found him lying upon his left
side, mouth and jaws wide open, with the tongue
protruding. Lips, tongue and inside of the mouth
of a dark blue color ; eyelids opened, pupil of the
eye contracted to the size of a pin's head. General
appearances of a man who had been suddenly
struck dead. Petechias all over the body, with spots
of ecchymosis in places. Rigor mortis very great.
I made post mortem and found no change in the
stomach. The only abnormal lesions were in the
heart. The left ventricle was contracted, the left
auricle slightly distended with blood, and the right
side very much distended.
To my mind, this poison acts on the left ventricle
of the heart, causing a clonic spasm, thereby cut-
ting off the blood from the general circulation.
Respiration may go on for a few moments after-
wards. I believe that there are many poisons in
different quantities, which produce vomiting and
other symptoms from their peculiar action on this
part of the heart. H. N. Dunnel, M. D.
Scranton, Penn.
Impure Milk as a Source of Zymotic Dis-
eases.— Another and most important source of
enteric fever, and one that intimately affects us all,
is our milk supply. Dr. Ballard has shown that an
outbreak of enteric fever at Islington, depended
upon the sewage contamination of milk from a
dairy-yard pump which had been used to increase
the value of the milk to the dairyman, at the expense
of the health and lives of his customers. Of 2,000
families resident within a quarter mile radius of the
228
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dairy-yard, 142 were supplied with milk from this
dairy, and 70 were invaded with enteric fever within
ten weeks. On examination Dr. Ballard found that
the pump from which the milk was watered was
contaminated by sewage infiltration into the tank
which supplied the water. There is little doubt that
many cases of fever and diarrhoea are produced in a
similar way in Dublin. It is sincerely to be hoped
that, Dr. Cameron's efforts notwithstanding, if our
dairymen will persist in diluting our milk, they will
restrict themselves to the Vartry water. Within the
last few weeks, Dr. Russell, the medical officer of
health of Glasgow, has reported an outbreak of en-
teric fever in his district, and he has demonstrated
that this outbreak was traceable to the distribution
of infected milk from the house of a dairyman in
which enteric fever prevailed. Out of 73 families
supplied by this dairyman, in four streets where a
milk census was taken, 22 had fever. Thirty-two
families supplied by this dairyman yielded 36 cases
of fever. The fever was of a fatal type. Out of 46
families there were six deaths, while there were no
deaths from it elsewhere. In two families so sup-
plied, the two individuals seized were the only mem-
bers of the family who used the milk.. The dates
of sickening corresponded with the other indications,
pointing to this dairy as the source of infection.
The fatal activity of milk as a cause of disease has
also been most carefully and scientifically investi-
gated by Dr. Taylor, of Penrith ; Dr. Bell and Dr.
Thorne. There can be little doubt that cholera was
introduced into the Richmond convict prison by
means of milk, in the epidemic of 1866, and I be-
lieve I narrowly escaped a similar visitation in my
own family, by similar means, in that epidemic. I
knew of one dairy which it is almost certain spread
cholera to their customers by means of milk, in
1866. It is highly probable that not only typhoid,
but small-pox, scarlatina, and even cholera, have
been communicated to people through the medium
of milk. It is, therefore, of the utmost public im-
portance to inquire into the sanitary condition of the
cow-sheds and dairy-yards.
The following is a graphic description of the
dairy-yards in the south side of the city, by Mr.
Benson Baker, of London, who published some
notes on a sanitary tour through Dublin, about two
years ago. Any one who will take the trouble to
investigate the matter now, will find it equally ap-
plicable : — "In the most densely-populated and
fever-infected district, in close vicinity to the corpor-
ation manure depot in Marrowbone Lane,. are to be
found the cow-sheds and dairy-yards of Dublin.
These yards, like the neighborhood, are abomina-
bly filthy; manure is allowed to accumulate in
heaps, from which may be seen small, black, fetid
streams flowing into the open streets. The effluvi-
um from these yards is absolutely poisonous, and is
only equaled by the atmosphere in the cow-sheds.
In this district man and beast alike fall easy victims
to preventable disease." Speaking of the condition
of the cows, he adds:— "Dr. Cameron says that
the loss from pleurq-pneumonia sustained by Dublin
dairymen is at least 10 per cent., yet the dairymen
cannot be convinced that the disease is contagious,
and, therefore, unless under compulsion from the
sanitary authorities, they never disinfect their prem-
ises after the removal of diseased beasts from
them. The vital powers of the cows are lowered
by their constant respiration in close fetid stables.
In some of the sheds the cubic space allowed for a
large cow is less than the minimum — viz. , 300 cubic
feet of breathing room — allowed a man in a regis-
tered lodging-house. The cows were so close to
each other that it was impossible that they could all
lie down together. On questioning the owner on
this point he facetiously replied, ' Gorra, sir, they
take it turn about.' This repartee might excite a
laugh if the occasion of it did not inflict cruelty
on the beasts, and tend to affect the people with dis-
ease. It is not surprising to learn that milk obtained
from cows herded together in such unsanitary con-
ditions, not only conveys foot-and-mouth disease,
but typhoid and other zymotic diseases to the con-
sumer." In Dr. Mapother's street-list of cholera in
1866, kindly lent for the purpose of this lecture,
many dairies are included as having been invaded
by this disease. Dr. Reynolds has shown you how
to distinguish good milk from bad in many ways,
but, unfortunately, no means is as yet known for
distinguishing milk poisoned by disease germs.
The importance of a pure milk-supply comes so di-
rectly home to every one of us, that it forms a suffi-
cient apology for the length to which its discussion
has been prolonged. — Extract from a paper by Dr.
Grimshaw in the Med. Press and Circular, April
16th, 1873.
The Action of Quinine. — A letter of the cele-
brated physiologist, Helmholtz, which Binz pub-
lishes (Pharmacological Studies on Quinine), is of
great interest. Helmholtz suffered for twenty
years from "hay fever." In recent years he dis-
covered vibrions of a peculiar sort in the secretions
of his nose. After becoming acquainted with Binz's
experiments, according to which all inferior organ-
isms are easily destroyed by quinine, he made the
trial on himself with a solution of 1 to 750. He in-
jected it into his nose, and found that the dreadfully
troublesome symptoms of hay fever disappeared
directly. Next year (1868), as soon as the illness
showed itself, he again injected the quinine, and the
development of the disease was suppressed. He
supposes that the vibrions, of which he gives a
sketch, are, perhaps, the cause, or at all events a
complication, of this specific catarrh. The fact
that the vitality of a great many infusoria is bound
to certain seasons and periods of the year argues
for the former idea, as also do the other circum-
stances of the case. If the local application of
quinine is to be of use, it must, as Helmholtz par-
ticularly mentions, also cleanse the little corners
and recesses of the nose proper, as the vibrions
seem to be chiefly there.
[Quinine is not only antiseptic, as shown by Binz,
Pringle and others, but as demonstrated by Adolph
Martin, of Giessen, it possesses the power of pre-
venting, or at least limiting, the pathological migra-
tion of the blood-corpuscles into the mucous tissues,
and it produces this effect: (a) by impairing the
vital properties of the existing white corpuscles ; (b)
by hindering the generation of new white corpus-
cles, and (c) by restraining the dilatation of the ves-
sels. Therefore we might reasonably expect benefit
from its antiseptic power in such cases as the one
above, in whooping-cough, diphtheria, &c, locally
used. It might also be of service, internally and
locally, as a remedy to prevent or moderate the se-
cretion of pus, especially on mucous surfaces. —
J. C. M.]
The Medical Union.
229
The Medical Union
A MONTHLY JOURNAL
Of Medicine, Surgery, and the Collateral Sciences.
Editors :
EGBERT GUERNSEY, M.D. CHARLES E. BLUMENTHAL, M.D.LL.D.
JOHN C. MINOR, M.D. ALBERT E. SUMNER, M.D.
H. M. PAINE, M.D.
Published on the First of each Month, by
C. T. HURLBURT, 898 Broadway, New York.
NEW YORK, OCTOBER, 1873.
" A regular medical education furnishes the only presumptive
evidence of professional abilities and acquirements, and ought to be
the only acknowledged right of an individual to the exercise and
honors of his profession." Code of Medical Ethics, Amer. Med-
Ass., Art. iv, Sec. i.
THE PROFESSION AND THE MEDICAL
COLLEGES.
We doubt whether, at the present time, a medi-
cal diploma entitles its holder to the slightest con-
sideration or respect even in unprofessional minds.
So far as the profession itself is concerned, including
even the faculties of the medical colleges from
which the diplomas are issued, the opinion is well
nigh unanimous, that the degree of Doctor in Medi-
cine, considered as a certificate of professional schol-
arship, is not worth the parchment it is written on.
And this arises from certain facts that are so evident
as to scarcely need recapitulation. But one fact is
pre-eminent — namely, that a medical diploma is no
evidence of either learning or ability, because it is
granted by unqualified and incompetent persons.
The title of professor is as worthless as that of
doctor. The position of professor in a medical
college is gained, not by the force of scholarly abili-
ty nor by the demonstration of peculiar fitness for
the duties of the position, but by personal influence
with the trustees or faculty. There is not a medical
college in existence in this country that does not
include among its faculty some who are notoriously
incompetent for the positions they hold, either from
positive ignorance or from lack of teaching ability,
and generally from both. Upheld by the force of
one or two eminent names, these faculties issue
their announcements and attract as many students
as possible to attend on the instruction of incompe-
tent teachers. The natural result follows that
always occurs when the blind lead the blind. But
after such a course of instruction the final examina-
tion for the degree takes place, and it "would appear
that the deficiencies of the student and the incom-
petence of his instructors would then be made
evident. Nothing of the kind ; the faculty who
teach are also the examiners who pass upon the
qualifications of the student, and, when the faculty
grant a diploma, they certify not only to the ability
and learning of the candidate, but also to the learn-
ing and ability of themselves. Thus it happens
that degrees are easily obtained.
This would be amusing were it not disgraceful.
The profession is awaking to the fact that a higher
medical education is a measure that is being forced
upon the medical colleges instead of emanating
from them. These institutions are now on trial
before the profession and the public. They have
been entrusted with the serious responsibility of
educating students in every branch of medical
science. In their hands the honor of the profession
has been placed for safe keeping, with the under-
standing that it was never to be bestowed upon the
unworthy. Admission to the ranks of the medical
profession can only be obtained with their consent,
under their supervision, and with their guarantee
that the candidate is thoroughly qualified and com-
petent. They have accepted this trust and under-
taken the task. We have supported them by send-
ing students, by contributing time and money, and
by permitting them to represent the profession.
Has the trust been worthily bestowed and honor-
ably kept? Have the medical colleges demon-
strated their ability to elevate the standard of medi-
cal culture and to preserve and promote the best
interests of the medical profession ? Are they
constantly striving to serve the profession and not
themselves ? Does each year find them more rigid
as to the qualifications of the teachers, and more
thorough and complete in the manner and matter of
instruction ? Do they signify their willingness to
have the profession judge impartially of the actual
worth of their work? Will they be estimated by
the value of their diplomas in the eyes of the pro-
fession? If not, what a sad confession of judg-
ment !
What are the medical colleges ? Are they the
masters or the servants of the profession ?
They are dependent on the profession for support
and constantly appeal to it for patronage. They
profess to meet the wants of undergraduates and
undertake to save us the trouble and responsibility
of educating our students. They are in fact the
servants of the profession. As servants, then, is it
reasonable that they should furnish their own testi-
monials of ability and character ?
We shall look in vain for any practical response,
on the part of the colleges, to the growing demands
of the profession. The facts of the case are so
plain that there is no necessity for a confession, on
230
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their part, of a betrayal of trust. None are so well
aware of the general incompetence of medical
teachers, the deficiencies of medical education and
the worthlessness of medical diplomas as the facul-
ties of these very colleges, and they must meet this
question of a higher education either by silence or
evasion.
Meantime Our duty is plain, and that of every
member of the profession is equally so. We must
agitate this question in every possible way, in our
periodicals, our societies, by private and by political
influence, until we force the colleges to adopt such
methods and such men as will meet the wants of
the profession. Every step gained must be followed
by another advance. The duty of the hour is the
earnest and hearty support of the law which pro-
vides a State Board of Medical Examiners. We do
not consider this measure alone as sufficient in itself
to accomplish the reform in medical education.
There may be some defects in its provisions, but it
is a step in the right direction, and its active sup-
port will lead to good results by a shorter way than
any other. After years of fruitless discussion the
remedy for the evil is now at hand, and it only re-
quires an intelligent appreciation and support of
the present law to obtain further and more stringent
safeguards in the future.
THE LESSON OF THE HOUR.
Another panic has ruffled the great sea of
business life. Starting in Wall street, the financial
center of the Western World, its influence has
been felt in every city, and town, and hamlet, from
one end of the land to the other. So closely linked
together are the interests of the nation that the pro-
ducer and the consumer, the money-king with his
millions, and the poor laborer happy if his daily
toil will supply even the ordinary comforts of life to
his family, are so dependent upon each other that the
influence of a great financial panic such as we have
just experienced, and which, many fear, has not yet
spent its force, is felt by all.
During the heighth of the recent panic, when the
Stock Exchange was closed, and one firm after
another was going down before the storm, the ac-
cumulations of a lifetime swept away in a few hours,
we passed through Wall and Broad streets, to
notice the effect upon those men who have so
much to do in manipulating the nation's wealth,
and whose power is so potent for good or evil. It
seemed as if they were gathered together at the
funeral of some loved friend. Men stood in groups
or alone, in every doorway, and along the street
talking in hushed voices and with sad faces, or
silent, as if their speech was gone and their power
to act paralyzed. As they go to their homes and
shut themselves within their houses, they cannot
shut out the busy thoughts which whirl through
their brains. They close their eyes, but sleep does
not come to refresh and strengthen. Severe mental
labor — that brain-work which absorbs every faculty
of the mind — often drives away sleep for the time,
but this cannot last long without its telling fear-
fully on the physical system. The mother, in the
intense anxiety of watching over her child, will
scarcely close her eyes for days, but unless her
strength is kept up by appropriate food, by and by
when the the strain is taken off, a fearful reaction is
likely to follow. Balzac and Dumas, in writing their
works, would shut themselves in their room, and
work night and day with but slight intermission.
Boerhave mentions that when on one occasion he
was intently engaged in a particular study, he did
not close his eyes for six weeks; and Gen. Pichegru
said that for a whole year, when engaged in active
campaign operations, he did not sleep but an
hour in a single night. A few years ago, when a
panic occurred in New York which threatened to
overwhelm in financial ruin nearly every promi-
nent merchant in the city, a friend and patient,
one of the leading merchants in the city, with im-
mense responsibilities resting upon him, found him-
self unable to snatch more than an hour or two of
sleep in a single night for some weeks, and yet,
thanks to a vigorous constitution, an unusually clear
head and an immense amount of nerve force, which
was kept up by nutritious food and a liberal supply
of champagne, he passed through the crisis with-
out any apparent detriment to his physical health.
During severe mental labor of the brain there is
an increased flow of blood to it, and if this labor
is long continued the vessels are apt to lose their
power of contraction when mental activity is dimin-
ished, and hence the sleeplessness as the vital fluid
continues to surge upward to the brain.
We do not believe that brain-work in itself begets
insanity ; but it does, when long continued without
being supplied with the necessary nerve nutriment,
lay the foundation for a host of maladies, some of
which, reacting on the nervous organism, produce
serious mental disturbances. No matter whether
the person has passed through any severe period of
excitement or not, years of close and constant appli-
cation, the mind constantly turning in one channel,
will assuredly, sooner or later, unless great care is
taken to keep up the supply of nerve force and the
functions of the body in an active condition, tell in
more or less mental and physical prostration.
By and by, this brain-worker, neglecting his
bodily health, begins to feel a want of clearness in
his ideas. Work becomes a labor to him; his
mind seems to have lost its elasticity, now and then
his memory seems defective, his plans are hazy and
The Medical Union.
231
indistinct, and he loses his relish for what was once
his greatest pleasure. Let him pause here, let him
heed the warning which comes to him in his waning
faculties, that his brain has been overworked, and
all his mental faculties are being crushed out, and
all may yet be well ; but just as surely as he fails to
heed these warnings, the inevitable retribution will
follow. Where it will strike will depend, to a very
great extent, upon his previous habits and the ten-
dency there may be to local weakness or hereditary
disease. Sometimes the heart gives way, sometimes
the stomach ; or, again, some hereditary taint which,
with proper care, may have never awakened into
activity, now starts into life and power, and speedily
sucks up the last spark of vitality in the overworked
and weakened form.
This period of mental excitement through which
the business world is now passing, as it uses up the
brain force, exhausts also the recuperative power,
and plants the seeds of future physical suffering.
Men do not willingly court disease. They are not
many who, knowing the facts, would rush into the
jaws of death or brave the dangers to which their
course expose them. Wealth and fame may be
very sweet, but not sweet enough to sacrifice health
and life. It is because they do not realize the deli-
cate organization of their own system, and because
too often there is no kind friend to admonish
them of the danger and point out the remedy,
that they are swept along the rushing tide until
the worn and shattered bark sinks beneath the
waves.
In the days when the armies of Rome were borne
in triumph throughout the world, as the victorious
general returned at the head of his conquering legions
and was drawn in the car of victory through the
thronged streets, by his side was placed one to whis-
per in his ear as the plaudits of the crowd filled the air,
" Remember thou art mortal" Every man should
have in his physician not merely the medical adviser,
but a friend whose interest in him is above dollars
and cents, who would not hesitate to point out
frankly any errors he might see in his habits of living,
and who possessed the ability to give a satisfactory,
scientific explanation of his conclusions. It is the
physician and the friend whose voice should be
heard whispering in his ear in the thronged street,
in the headlong rush of business, "Remember
thou art mortal, there is danger before you, the
frame is wearing out, pause now or it will be too
late."
One reason why the physician has not a stronger
influence upon the community is, that his conduct
does not in all cases beget confidence. There is a
strong feeling abroad that his interest in his patient
is confined to his pocket, and that his advice savors
of merchandise. Wrong as this impression is, in
many cases it is, alas ! often too true. Let the phy-
sician gain the confidence of his patient, and make
him feel that he strives to carry out honestly and
faithfully the highest duties of his profession, and he
will have an interest over him for good beyond cal-
culation. Many a life might be prolonged for useful-
ness, and many a family circle made bright and
happy, which but for his kindly influence would be-
come desolate. Let the physician assume his true
position in society, his judgment guided by profound
scientific knowledge, enlarged views and earnest de-
sire for the best interest of his patient, and his influ-
ence will be felt with tremendous power in harmon-
izing the discordant elements and holding in check
those passions which do so much to disturb the
current of human life.
INACCURATE CHOLERA REPORTS.
Dr. John C. Peters, who for the past few years
has been exceedingly fond of ventilating his ideas
on cholera on all occasions, serving up his old
treaties on that subject in every conceivable form
and shape in daily papers, and in medical journals,
has not been very fortunate in his recent Western
trip. No sooner did the news of the cholera epi-
demic at the West and South reach our ears, than
"Cholera Peters" starts off on a tour of investiga-
tion through the infected district, and in due time
returns to his native city, fully charged, and pro-
ceeds in a lengthy report to astonish and enlighten
the profession.
All this might have been very praiseworthy and
commendable if the character of his mind fitted him
for an intelligent investigation of the important sub-
ject, and if his report could be relied upon as ex-
pressing the real facts. But we are forced to believe,
from the statements of Western journals, that Dr.
Peters is not much more profound and accurate in
his investigation of cholera than in some other
matters. Dr. William R. Bowling, one of the edi-
tors of the Nashville Medical Journal, who has de-
voted much attention to cholera, and who has
the advantage of residing and practicing where it
prevailed, declares, in the most positive terms, that
the report of Dr. Peters " is a tissue of misrepre-
sentations from beginning to end."
The Pacific Medical and Surgical Jourjta I 'remarks
that "many of the reports on the condition, prog-
ress and circumstances of epidemic cholera, though
coming from high and often official sources, are so
incompatible with the personal experience of saga-
cious observers, and so saturated with the theo-
ries of the reporters, as to throw a deep shadow of
suspicion over their truthfulness."
We would suggest to Dr. Peters, that having inves-
232
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tigated homoeopathy and cholera to his entire satisfac-
tion, that he now permits his brilliant intellect, with
its profound and far-reaching powers of analysis, to
launch out on other fields of scientific exploration.
However important the subject of cholera may be,
there is danger that long-continued brooding over
it may engender the disease in its worst form in
his own person, whereby the profession would be
called upon to mourn one of its most modest, con-
sistent and scientific members.
BOSTON UNIVERSITY.
The school of medicine of the Boston Univer-
sity has just sent out its first annual announce-
ment.
In looking over the faculty, we notice not only
the names of those who have long been prominent
in our school as able practitioners and clear and
vigorous writers, but in some of the chairs not
necessarily homoeopathic men have been selected,
recognized by the scientific world as of great ability
in their special departments. We are glad to see
that Dr. Joseph Buchanan has been appointed to
the important chair of physiology, insuring to the
students a thoroughness of instruction and an in-
tellectual treat such as will be enjoyed by no other
class in that department in any college in the
United States. Dr. Buchanan is one of the most
original thinkers and instructive speakers in those
departments, which he has made a life study, in the
country. If, with the very able faculty and the
great facilities for clinical teaching at their dispo-
sal in the city of Boston, the medical department
of Boston University does not soon take higher rank
than its sister school of Harvard, we shall be very
much disappointed. The one linked to the tradi-
tions of the past, and fast bound in the fetters of a
sectarian bigotry, will be forced by the broader lib-
erality of its youthful rival to either keep pace with
the advancing spirit of the age, or to take its place in
the background. We heartily wish success to the
new institution.
Chloride of Potassium in Epilepsy. —
Dr. Lander uses {Scalpel, Belgium) chloride of
potassium instead of bromide of potassium, in
epilepsy. He mentions the following advantages
in the employment of the substance. It is more
active, is but one-sixth the cost, and has not
the secondary effects of the bromide. He begins
with small doses and has been able to continue the
use of the substance for months without any incon-
venience, in daily doses of from one drachm to a
drachm and a-half. According to Dr. Lander,
bromide of potassium is transformed into the
chloride in the stomach. This is, therefore, an ad-
ditional reason for prescribing it at once in this
latter form.
{Transactions of Societies,
UNIVERSITY OF THE STATE OF NEW YORK.
THE law and regulations controlling the
ACTION OF THE STATE BOARD OF MEDICAL
EXAMINERS.
MEMBERS.
JohnF. Gray, M. D., LL. D., President of the
Board and Examiner in the Department of Institu-
tes of Medicine, Fifth Avenue Hotel, New York.
H. M. Paine, A. M., M. D., Secretary and Ex-
miner in the Department of Chemistry, 104 State
street, Albany.
John A. McVickar, A. M., M. D., Examiner in
the Department of Allopathic Materia Medica and
Allopathic Therapeutics, 130 East Seventeenth
street, New York.
John C. Minor, M. D., Examiner in the Depart-
ment of Surgery and Anatomy, 10 East Forty-first
street, New York.
Wm. H. Watson, A. M., M. D., Examiner in
the Department of Pathology and Diagnosis, 270
Genesee street, Utica.
George E. Belcher, A. M., M. D., Examiner in
the Department of Clinical Medicine, 43 East
Twenty-first street, New York.
Henry B. Millard, A. M., M. D., Examiner in the
Department of Homoeopathic Materia Medica and
Homoeopathic Therapeutics, 47 East Twenty-fifth
street, New York.
W. S. Searle, A. M., M. D., Examiner in the
Department of Obstetrics, 132 Henry street,
Brooklyn.
Samuel A. Jones, A. M., M. D., Examiner in
the Department of Histology and Physiology,
Englewood, N. J.
Copy of the Law Passed May 16, 1872, Author-
izing the Appointment, by the Regents of the
University, of State Boards of Medical Exam-
iners.
Section i. The Regents of the University of
the State of New York shall appoint one or more
boards of examiners in medicine, each board to
consist of not less than seven members, who shall
have been licensed to practice physic and surgery
in this State.
§ 2. Such examiners shall faithfully examine all
candidates referred to them for that purpose by the
Chancellor of said University, and furnish him a
detailed report, in writing, of all questions and
answers of each examination, together with a separ-
ate written opinion of each examiner as to the ac-
quirements and merits of the candidates in each
case.
§ 3. Such examinations shall be in anatomy,
physiology, materia medica, pathology, histology,
clinical medicine, chemistry, surgery, midwifery and
in therapeutics, according to each of the systems of
practice represented by the several medical socie-
ties of this State.
§ 4. The said reports of examinations, and the
annexed opinions of the examiners, shall forever be
a part of the public records of the said University,
The Medical Union.
233
and the orders of the Chancellor addressed to the
examiners, together with the action of the Regents
in each case, shall accompany the same.
$ 5. Any person over twenty-one years of age,
of good moral character and paying not less than
thirty-five dollars into the treasury of the Univer-
sity, and, on applying to the Chancellor for the
aforesaid examination, shall receive an order to that
effect, addressed to one of the boards of examiners,
provided he shall adduce proofs satisfactory to the
Chancellor that he or she has a competent knowl-
edge of all the branches of learning taught in the
common schools of this State, and of the Latin lan-
guage, and that he has diligently studied medicine
not less than three years, under the direction of one
or more physicians duly qualified to practice med-
cine, or has himself been licensed, on examination,
by some medical society or college legally em-
powered to issue licenses or degrees in medicine.
§ 6. The Regents of the University, on receiving
the aforesaid reports of the examiners, and on find-
ing that not less than five members of a board have
voted in favor of a candidate, shall issue to him or
her a diploma, conferring the degree of doctor of
medicine of the University of the State of New
York, which degree shall be a license to practice
physic and surgery.
% 7. The candidate, on receiving said diploma,
shall pay to the University the further sum of not
less than ten dollars.
§ 8. The moneys paid to the University, as afore-
said, shall be appropriated by the Regents for the
expenses of executing the provisions of this act.
§ 9. The Regents may establish such rules and
regulations, from time to time, as they may deem
necessary to insure the faithful execution of the
provisions of this act.
% 10. This act shall take effect immediately.
University of the State, New York, )
Office of the Regents, V
Albany, September 5, 1873. )
Rules and Regulations Established by the Regents
of the University.
1. Any person wishing to be examined as author-
ized by the fifth section of the act referred to, after
he shall have made the payment required in said
section, shall apply in writing to the Chancellor for
such examination, and shall also present to him in
writing the preliminary proofs as to age, character,
attainments and professional studies required by the
said act.
2. If the proofs thus presented be satisfactory to
the Chancellor, he shall give his certificate thereof
in writing, to be filed with such proof in the office
of the Regents, and grant an order addressed to any
Board of Examiners appointed under the said act,
authorizing such board to examine such candidate
as required by the said act and these rules, and to
furnish to the Regents of the University, in writing,
a full report of such examination and the opinions
of the examiners, within such time, to be named in
said order, not exceeding three months from the
date thereof, as he may deem to be reasonable,
which time may be extended by the Chancellor on
satisfactory cause being shown to him.
3. The chairman of the Board of Examiners shall
convene the board within thirty days after receiving
the said order, giving, at least, ten days' notice in
writing to its members, and also to the president of
each of the State Medical Societies of this State, of
the time and place of meeting, and of the name of
the candidate or candidates to be examined.
4. The said board may, from time to time, make
such rules in writing, as to the attendance of its
members and for its own conduct and government,
as it may deem proper; a copy of which rules shall
be filed with the Secretary of the University, and
all such rules shall be subject to repeal, alteration
or amendment by the Regents.
5. The examination of every candidate shall be
^open to the members of the medical profession,
wherever resident, and to the Regents of the Uni-
versity. It shall be conducted by examination
papers, to be furnished by the Regents to the chair-
man of the Board of Examiners in sealed envelopes,
in sets of not more than five questions in each envel-
ope. At the commencement of the examination, the
chairman of the board shall deliver one of said en-
velopes, so sealed, to each member of the board
present and to each candidate, and shall thereupon fix
and declare the time to be allowed in which to an-
swer that set of questions. The questions shall be
the same for all the candidates at the same exam-
ination.
The answers shall be in writing in the following
form :
Answer of A. B. to the Questions Hereto Annexed.
, and so
To the first question he says,
on through all the questions.
When the candidate shall have completed his
answers to all the questions, or the time fixed by
the chairman shall have expired, he shall sign his
name to the answers and annex thereto the ques-
tions, and deliver the same to the chairman, and
so on with other sets of questions until the whole
examinations be completed.
The examiners may also examine the candidates
by oral questions after the paper examination is con-
cluded; but each oral question shall be correctly
written down at the time, before it is answered, and
the answer thereto shall also be immediately writ-
ten down, and such oral examination, as well as the
paper examination, shall make part of the report
to the Regents.
No candidate shall, during the time devoted to
his examination on any one set of questions, con-
sult any person, book or paper, or leave the room
in which said examination is conducted.
6. Every member of a Board of Examiners shall,
within twenty days after the issuing of the order
provided for in the second of these rules, send to the
Regents of the University (addressed to the Secre-
tary) at least fifty written questions proper to be
put to the candidates, to be classified in any way
he may deem proper. From said questions, and
others to be proposed by the Regents or other per-
sons, the Regents shall select the questions to be
put to the candidates as aforesaid.
7. Any candidate who shall be commended for
distinguished merit in the report of the Examining
Board, and who shall also present to the Regents a
dissertation on some medical topic, written in either
Latin or English, may, if the Regents so direct, re-
ceive special notice of such merit at the University
Convocation next succeeding his examination.
8. The degree of "Doctor of Medicine of the
234
The Medical Union.
University of the State of New York," which may
be granted in conformity to the said act, will be
conferred in form, either at a meeting of the Re-
gents, or at the then next University Convocation.
9. The Secretary of the Regents is hereby au-
thorized, out of the moneys which may be received
from candidates, pursuant to the fifth and seventh
sections of the said act, to pay in the first place all
proper incidental expenses attending the examina-
tions and proceedings aforesaid, to be audited by
him, and then the actual traveling expenses of the
examiners, or such part thereof as the fund may
warrant, to be audited in like manner.
10. Any vacancy which may occur in any Board
of Examiners, when the Regents are not in session,
may be filled by the Chancellor by an appointment,
to continue in force until the next meeting of the
Regents.
11. The Secretary of the Regents is directed to
communicate a copy of these rules and regulations
to the president of each of the State Medical Soci-
eties and Medical Colleges in the State.
THE NEW YORK COUNTY HOMOEOPATHIC
MEDICAL SOCIETY.
The New York County Homoeopathic Medical
Society held a regular meeting at the Homoeopathic
Ophthalmic Hospital, on Wednesday evening, Oct.
8th. Dr. T. F. Allen was in the chair. The
evening was appropriated to discussions upon
diseases of the eye, ear, and throat, and papers
were read by members of the bureau on these
topics.
The chairman of the bureau, Dr. Liebold, read an
able article upon the treatment of iritis. The ap-
plication of cold, he said, seemed theoretically to
be indicated. The activity and rapidity of the in-
flammatory action would suggest it as the most
proper remedy. But experience showed most con-
clusively that it is only palliative in its action, and
that oftentimes it is productive of much harm.
Moist heat seemed to fulfill the indications more
fully than the previous remedy. But its use needed
great and constant care, as, frequently, from the
heedlessness of the patient or his attendant, the
moist application was allowed to become cold and
produce disastrous results. Its application, also,
oftentimes renders the patient very susceptible to
changes of temperature, and occasionally induces
neuralgia. When the proper care was used, its ap-
plication produced very successful results.
Dry heat, however, has been far more successful
in his hands. He applies it by means of layers of
cotton batting fastened lightly over the eye.
He had abandoned the treatment by bandaging,
as by the pressure the tears were pent up within
the folds of the eye for a time, and then gushed out
over the face, and the eye became irritated and
painful under its application.
In speaking of internal medication, he mentioned
aconite first, as appropriately heading the list of reme-
dies ; in the early stages of acute local inflammation
its use was of great value, and in patients of tender
years it was especially beneficial.
Assafcetida was indicated where there were
violent throbbing pains in the temples. It was also
more suggested in the female sex than in the male.
Natrum muriat. often controlled violent throbbing
pains, and his experience with the action of the
remedy was confirmed by that of many others.
Cedron was highly beneficial in supra-orbital neu-
ralgia. If the higher potencies of this drug did not
suffice for a cure, the lower ones should be used.
Merc, corrosiv. enjoys a good reputation in the
cure of this disease. Its administration should not
be pushed until salivation was produced, but the
middle potencies should be persistently given for
some considerable length of time.
Terebinth had proved to be a useful remedy in his
hands. He regretted that the provings of this
drug were so incomplete. The doctor then read an
interesting report of a case furnished by a German
physician. A patient suffering from amblyopia and
commencing alteration of the optic nerve was ex-
posed to the inclemencies of the weather, took cold,
and as a result the perspiration of the feet was
checked. To relieve this, the feet were bathed
freely with spirits of turpentine, and not only was
the perspiration once more established, but to the
great surprise and joy of the patient the eyesight
gradually improved and was eventually restored to
its normal condition.
Dr. Liebold had obtained gratifying results from
its use, and thought it indicated in iritis when of a
rheumatic type. The medicine should only be
used in the first or second dilution.
Atropine should always be instilled into the eye
as early as a diagnosis is clearly made. The cases
are but few which do not come quickly under its
effects. Its action should be rapidly produced, and
if no effect is obtained within twenty-four hours, its
use should be entirely omitted for a time, as its ap-
plication in these circumstances is liable to cause
irritation and do harm rather than good.
The disease ordinarily yields rapidly to treatment,
and seldom is so uncontrollable that iridectomy
must be performed as a last resort.
Dr. Norton read a paper upon atropine, its uses
and abuses. He spoke first of the nature and
properties of the drug, and of the strength of the
solution that was ordinarily applied. He explained
its action upon the eye, and the contra-indications
for its use, laying especial stress upon its avoidance
in glaucoma.
In speaking of the diseases in which its use was
indicated, he dwelt largely upon its application in
iritis, and the beneficial results that it produces in
that disease. The question had been often asked
whether homoeopathy can cure iritis without the aid
of atropine, and he would most emphatically
answer it, Yes, it can be cured. When the cases are
seen early, and before an exudation has formed,
homoeopathic remedies internally administered suf-
fice to control the disease.
In keratitis it is extensively used by the old
school. Under homoeopathic treatment it is not
requisite, and should therefore never be used except
when ulcerations are present. In these cases it is
highly applicable, as it relieves the intra-ocular
pressure to a great degree.
Atropine is also of great value before and after
operations. The doctor spoke quite fully upon the
indications for its use in these cases.
Dr. Houghton presented an able and interesting
paper upon nervous deafness, and its treatment,
illustrating his remarks by beautiful photographs of
the ear, which have been recently gotten out by the
distinguished German aurist, Dr. Adam Politzer,
The Medical Union.
235
of Vienna. The doctor spoke of the dependence
of this disease upon disturbances of the auditory
nerve, and of the comparative infrequency of the
disease. He took occasion to speak of the common
belief of the laity in regard to the frequency of this
malady, and until the last five years, of the incor-
rect ideas that even physicians held as to its com-
monness. As formerly in ophthalmology when
the patient could see nothing and the doctor could
also see nothing, the disease was pronounced amau-
rosis, so in otology when the patient was deaf and
the doctor did not recognize any cause for the im-
pairment of hearing, it was pronounced nervous
deafness. And this was especially done if the
patient was of a nervous temperament, and the
doctor's opinion was credited for wise sagacity.
Nervous deafness may emanate from diseased con-
ditions of the membrana tympani, and of the cavity of
the middle ear, which have produced disturbances of
tension and equilibrium in the internal ear. Its gen-
eral causes may be considered as of two kinds, di-
rect and indirect. Under the former may be classed
injuries, fractures and the resulting extravasations
or exudations ; also the action of quinine, concus-
sion of the auditory nerve, as by loud explosions,
and by the pressure exerted when either suddenly
ascending or descending great distances.
As the remote or indirect causes, may be classed,
syphilis, the exanthematous fevers, tumors and
aneurisms.
The symptoms of this malady are absolute deaf-
ness, nausea and vertigo. There are many diseases
of the ear which produce similar symptoms. Impact-
ed cerumen, dry catarrh or sclerosis may and often
do produce similar symptoms, and nervous deaf-
ness can only be diagnosed by the process of exclu-
sion, and by the aid of the tuning fork. Real, ab-
solute nervous deafness is of very rare occurrence, and
it is of the highest importance that an exact and accu-
rate diagnosis in every case be made, as the prog-
nosis of the different forms of ear troubles varies
very greatly.
In speaking of the remedies used in this affliction,
the doctor said that nitre, which seems to be indi-
cated in this class of cases, had not given at all
satisfactory results.
Causticum has a well-marked action upon the
facial nerve, as we all know, and has proved of ben-
efit.
Silicea has been recommended by Dr. Searle, of
Brooklyn, and our experience in the hospital has
confirmed its beneficial action.
Nux-mosch. and phosphorus have an action upon
the auditory nerve, and are sometimes useful. Elec-
tricity bids fair to become a remedial agent of the
first order in this disease, and its use is becoming
daily more extensive. The aurist should not forget
to examine carefully the general condition of the
body, and to take in the totality of the symptoms.
Dr. Seeger read a long paper upon the treatment
of croup, by the inhalation of medicated vapor.
He commenced by giving the etiology, pathology
and symptoms of croup, as recorded by Niemeyer,
and read an extensive list of cases bearing upon
this method of treatment which have been reported
by various foreign writers. He said that this method
was known to the ancients, although its use had
been more largely developed in recent times. He
said that he relied entirely upon the inhalation of
vapor, and so far the most satisfactory results had
crowned his efforts. He showed to the society a
large variety of nebulizers, one of which was of his
own invention. His apparatus is a croup spray-pro-
ducer, and consists of glass tubes which unite
the liquid into a spray, being of considerable length;
these are attached to the boiler of a steam appara-
tus similar to the one manufactured by Codman
and Shurtleff.
The doctor also presented a paper by Dr. Hallock,
upon the beneficial results obtained in croup, with
the inhalation of the vapor of iodine, the purport
of which has been already noticed in a former num-
ber of this journal. A few minutes were then given
to miscellaneous business, and the meeting ad-
journed.
Heuieuis of Boohs.
Bonninghausen's Homoeopathic Therapia
of Intermittent and other Fevers. Trans-
lated, with the addition of new remedies. By A.
Korndoerfer, M. D. Published by Boericke
& Tafel.
Intermittent fever has called forth more words
than ideas ; yet no malady is so submissive to the
will and imagination.
A dogged resistance has often overthrown an at-
tack, and the practice of the most ridiculous super-
stitions have even more frequently proved wonder-
fully curative. Disgust, also, as in swallowing urine
or a half-dozen of the cimex, has quickly silenced a
prolonged fever. Again, confidence is an army in
itself, — a physician firmly believing in the efficacy
of a certain remedy will accomplish many cures with
it, while his neighbors declare it useless. Honest
men have faithfully toiled over the pages of Bon-
ninghausen, and week after week have heard the
doleful cry: "I'm no better, doctor," while others
insist that they perform wonders under such guidance.
Are not many of the symptoms the product of
other causes than the drugs mentioned ? Has not
imagination helped any? Is it possible that the
hundreds of true men who have gone to the bedside
with such works in their hands and ingloriously failed
were not faithful to the law ?
Works devoted to intermittents have too often
proved of doubtful value ; an appeal to the general
symptomology is far safer, and there we are more
likely to discover what " gets worse after touching
things," " after eating," " after drinking," etc.
The worst feature of such books is (unintentionally)
to encourage an overestimate of the chill, fever, and
sweat, and a depreciation of the conditions which
prolong the fever. In persons otherwise well, the
fever speedily yields to properly selected remedies ;
while in those who have been crushed by care and
grief, or wasted by disease, and they who have over-
burdened their livers by excesses, either of the brain
or stomach, it is very difficult to uproot it, or even
allay its symptoms, unless utterance be choked awhile
by the free use of mercury, quinine, strychnine,
arsenic, or iron.
Little can be done to save us from such a resort
while this greediness for symptoms heaps up such a
mass of useless matter that only serves to hide many
pure and well-proven gems of the materia medica.
Such things have done more than its worst enemies
236
The Medical Union.
to retard the law. Unfortunately, this applies in
some degree to much of our materia medica. Im-
aginary symptoms are daily poured into the journals.
Unproved assertions of some visionary enthusiast
are too often taken as statute law. In Bonninghau-
sen's time, such men lived and wrote, and he was
compelled to take from their pens. His work ex-
hibits an untiring hand, and for his diligence he must
be praised ; but whether we ought to thank any one
for a new translation without striking out a part, at
least, of the uncertain provings, is questionable.
The book is fairly printed and well bound.
The Atmosphere ; translated from the French of
Camille-Flammarion. By James Glaisher,
F. R. S., Superintendent of the Magnetical and
Meterological Department of the Royal Observa-
tory, Greenwich. With ten chromo lithographs
and eighty-six wood-cuts. New York, Harper
& Brothers, Publishers.
The work treats on the form, dimensions, and
movements of the earth, and of the influence exerted
on meteorology by the physical conformation of the
globe ; of the figure, height, color, weight, and
chemical components of the atmosphere ; of the me-
teorological phenomena induced by the action of
light, and the optical appearances which objects
present as seen through different atmospheric strata ;
of the phenomena connected with heat, wind, clouds,
rain, and electricity, including the subjects of the
laws of climate. The contents, it will readily be
seen, are of deep importance to all classes of per-
sons, the observer of nature, the agriculturist, the
navigator, and especially the physician. To the
physician it opens an immense fund of information
in a channel of investigation which has been too
much neglected, and gives him useful hints by pre-
senting scientific facts, not only as to the causes of
disease, but as to their prevention and cure. The
work is elegantly illustrated and written in a style
which, without sacrificing scientific accuracy, gives
it all the charm of a romance.
The American Cyclopedia; New York, D.
APPLETON & Co., 549 & 551 Broadway.
A GOOD cyclopedia is almost a necessity in every
library. It is in itself a library in every department
of literature, science, and art, to which almost daily
reference is made by all who have any desire to
keep posted in the march of events. The physician
finds it a work of quick and ready reference, post-
ing him in the various departments of science con-
nected with his profession, in the new discoveries in
chemistry, materia medica, and physiology, and
referring him to extended treatises on those subjects
if the epitome given is not sufficient to answer his
purpose.
In selecting so important a work as a cyclopedia,
to which daily reference is to be made for informa-
tion upon the various subjects which almost daily
come up for investigation, the first thought is to ob-
tain the one which will be of the most practical value,
and will give, in the clearest manner and the short-
est space, the information desired. The three most
popular works are, the Cyclopedia Britanica, Cham-
bers' Cyclopedia, and the American Cyclopedia.
The Britanica is an immense work, giving exhaus-
tive treatises on nearly every subject it discusses, of
great value, and indispensable in public libraries,
and among the chosen books in the editorial sanc-
tum, but for the hard-working business or profes-
sional man it is too large, and is placed at too high
a price. In general use, then, in this country the
choice lies between the American Cyclopedia, Cham-
bers', and perhaps Zill's. We have carefully ex-
amined and compared Chambers' and the American,
placing them on our table side by side, and com-
paring the articles. We find the American treating
a larger number of subjects, and all with more
fullness and clearness, than Chambers7, and to our
unprejudiced eye it seems a more valuable and prac-
tical work. This is a second edition of the one
published several years since, but every page has
been rewritten and every department brought fully
up to the times. The illustrations in this edition
form an important feature. They are well executed,
and the subjects wisely chosen, a simple illustration
often conveying a more intelligent idea than a whole
page of printed matter.
Human Longevity. By William I. Thoms.
F. S. A., Deputy Librarian, House of Lords,
New York, Scribner, Welford & Armstrong.
Mr. Thoms starts out with the idea that one hun-
dred years is the limit of human life, and that the
cases quoted of lives of over a century will not bear
the test of investigation. He takes up nearly all
the cases of great longevity quoted, sifts the evi-
dence with the skill of a detective, and shows to his
entire satisfaction, if not always to that of the readers,
that their claims are spurious. Our old friend,
Capt. Lahrbusr, comes in for a pretty thorough
overhauling, in which he attempts to prove the old
man has magnified his age by at least twenty years.
Fifteen years ago, when we first saw the captain, he
looked quite as old as he claimed to be, and from
evidence which to our mind is satisfactory, he has
not overstated his age. Life assurance has existed
in England since 1706, and yet in the experience
of the companies, notwithstanding their care in ex-
cluding those which, on a careful examination, were
considered unhealthy, only one case occurred where
the person reached a hundred years, and three cases
where they numbered ninety-nine years.
According to the last census, there were in the
United States 3,500 persons over 100 years of age,
and yet perhaps this number, if subjected to the
rigid scrutiny of Mr. Thoms, would be materially
lessened, as of all the cases published in England
he only finds four whose record stands the test of
his scrutiny. To those interested in the subject
discussed the work will be of value.
A Medical Hand-Book for Mothers. By
Alfred C. Pope, M. D. London, Henry
Turner, 1873.
This work is designed to assist the young wife and
mother in the management of her health, and in
providing for the wants of her infant. The infor-
mation given is of a practical character and such as
every mother should understand. The manner of
living is described, which, during the months of
pregnancy, will most contribute to the health of the
mother and the proper development of the child, and
The Medical Union.
23;
the means of regulating the indispositions which are
liable to occur during that period are plainly given.
An important chapter in the book, which every
young mother will appreciate, is that given to the
management of the young infant, in which she will
find plain and simple directions as to the food,
clothing, and general care of the child. The work
is pleasantly written, and if generally read would be
the means of saving many little lives who annually
perish through the ignorance of mothers and nurses.
Scientific i&leanings.
The Effects of Forests Upon Rain-fall. —
There seems to be a conflict of opinion and even of
evidence on this subject. While in some instances
a reduction is very positively alleged to have taken
place, in many others this result has not been ob-
served. Some very important effects of a different
kind are quite unquestionable. When the moun-
tain summits have been robbed of their wood, the
soil upon the upper slopes, deprived of the support
furnished it by the roots of the trees, is no longer
able to maintain its place and is washed down into
the valleys below. These are then sometimes over-
whelmed by a deluge of sand and gravel, which
covers up completely the fertile plains of the lower
districts, and renders them unfit for cultivation.
Mr. George P. Marsh, in his valuable work upon
Man and Nature, recounts some very destructive
instances of this effect among the Alpine valleys of
south-eastern France. The mountain summits thus
stripped of their soil become barren slopes of rock
down which the water rushes with rapidity and vio-
lence.
In the next place the rivers undergo a change of
the most serious kind. They lose their sustained
and equal flow and become irregular. The rain of
a summer shower drains rapidly from the precipi-
tous and rocky heights no longer covered by a soil.
It fills the bed of the stream, overflows it and passes
off in a torrent to the sea, leaving the stream shrun-
ken and insufficient till another storm of rain creates
another inundation. Thus brooks that formerly
were wont to turn mill-wheels, and do much valua-
ble work, are changed into irregular mountain tor-
rents, and not only lose their character of usefulness,
but become dangerous and destructive.
These effects have grown so marked, that the
European governments have been forced to recog-
nize them. They have even undertaken some
measures of protection against an evil so serious,
and have attempted to restore the wood of those
summits, which still retain a sufficient amount of
soil. In some instances the effort has proved suc-
cessful; and streams that had become so capricious
as to be worthless, are found to regain their former
constancy and fullness with the restoration of the
forests which had been ruthlessly cut down.
Few subjects are of more importance to us than
a right understanding of the disastrous effects of the
constant and rapid destruction of our native forests.
Every year the country is more and more denuded ;
and at length, the high price of lumber drives the
wood-cutters further and further up into the moun-
tains. Regions so precipitous as to have been hitherto
secure from intrusion are now reached by the axe.
From the windows of the rail-car, the traveler sees
upon the distant summits, great gaps in the forest,
where some adventurer, more enterprising than the
rest, has found means of bringing down in a season the
growths of a century; and soon we shall find it too
late to protect our rural districts from the dangers
which already threaten them.
Can the Infant Digest Starch ? — This very
important question is answered in the negative by
an Italian physician. It has been known that the
saliva of newly-born animals has not the power of
transforming starch into sugar. A recent experi-
menter has taken the pancreas from kittens and
puppies, and has ascertained that the pancreatic
juice, in these animals when young, is, like the
saliva, incapable of converting starch into sugar.
The hearing of this fact on the practice of giving
starchy food to very young infants is obvious.
New Means of Dilatation in Stricture
of the Urethra. — It simply consists in the
employment of a column of liquid about twenty
metres high, established by means of a funnel,
and containing about a pound and a-half of
water (boiled at 250 or 270 C.) and suspend-
ed above the patient's bed. An India-rubber
tube (about two metres long), and provided
with a cock in the middle of its length (so as to
moderate or suspend the current of water), and
having at its end a small glass pipe like an ordin-
ary syringe, which is to be introduced into the
meatus, connects the apparatus with the penis.
The glass end being introduced, the cock is more
or less opened at will, and slight pressure is exerted
on the glands, to prevent the water from running
outside. The water in the funnel is then forced
down by its own weight and runs down drop by
drop, dilating the stricture without pain, and,
through its local and antiphlogistic action rendering
the urethra pervious to sounds and bougies. The
patient can himself apply the apparatus, three
or four times a day, and when it is removed the
surgeon has only to make use of his bougies and
sounds.
Treatment of Chronic Diseases of the
Bladder with Injections of Healthy Urine.
— In No. 8 of the Pester. Med. Chir. Presse for this
year, Dr. Clemens proposes for the treatment of old
disorders of the bladder (such as catarrh, chronic in-
flammation produced by unhealthy urine, gravel, &c.)
a means which had already suggested itself to his mind
four years previously, and which he has since em-
ployed with success. His first case was that of a patient
whose bladder contained abnormal urine in a state
of putrefaction. After having failed in the use of
all known remedies, he made injections of fresh
and healthy urine, and with the best results. The
author advises to empty the bladder completely, and
to wash it out by means of an injection of tepid
water, which is allowed to run out after five minutes ;
a young and well fed individual is then made to
micturate directly and slowly into the syringe,
which is previously warmed to 25 ° (Reaumur).
The injected urine is allowed to stay some time in
the bladder. The injections must be repeated two
or three times in the day. Sometimes an immedi-
ate effect is observed, as happened in a case quoted
by the author, in which spasm of the bladder disap-
peared after the first injection.
238
The Medical Union.
Exploration of the Rectum by Means
of the Whole Hand. — In the Archivfur Klin-
ische Chirurgie, Dr. G. Simon states that it is pos-
sible to introduce the whole hand into the rectum
without producing any serious lesion. Dilatation
may be performed with or without previous section
of the sphincter. The patient being under the in-
fluence of chloroform, two fingers are gently intro-
duced, then three, then the whole hand, and even
the forearm. After the hand has reached the sacro-
vertebral angle, the fingers may be extended into
the abdominal region, and explore the situation
from the kidney to the umbilicus, without any dan-
ger. In this manner affections of the uterus, the
ovaries, and even the stomach and spleen, may be
diagnosed with greater certainty. On introducing
only one-half of the hand, the base of the uterus
and the ovaries may be explored. In men the fun-
dus of the bladder can be examined, and the exis-
tence of calculi detected. In two cases of ovarian
cysts, Dr. Simon was enabled by this procedure to
make out the length and thickness of the pedicle,
the absence of adhesions to the walls of the pelvis,
and the existence of fibrous tumors in the fundus of
the uterus. The diagnosis was confirmed by the
operation. Furthermore, Dr. Simon thinks that
dilatation with the whole hand may be the means
of curing fissures.
Madeira as a Health Resort. — That in-
valids, who visit distant climes in pursuit of condi-
tions more favorable to health than they can find at
home, are but too often lead by false hopes, is an
every-day observation. A writer in the London
Times, who went out to Madeira last year for the
benefit of his health, has proved the truth of this
observation by his own experience, and labors to
convince other invalids that they can find nearer
home advantages every way superior to those en-
joyed at Madeira. The temperature of that island
is, no doubt, remarkably equable, the thermometer
very rarely indicating under 6o°, or over 780 ; but
yet, from the latter end of February up to the date
of the writer's letter, the beginning of May, the
weather was as unpleasant as could prevail even in
England. During March there were keen, piercing
winds, and occasional hot sun, and April was a
succession of chilly, damp, and rainy days. Thus
the patient is almost sure to lose, in the discom-
forts of spring, all the strength he may have gained
during the summer and winter. A Portuguese never
condescends to let apartments, and the invalid must
put up with the very imperfect accommodations of
the hotels, where comfort and sanitation are en-
tirely disregarded. The writer regards the Madeira
climate as especially unfavorable to youthful invalids.
Finally, it would appear that every obstacle is placed
in the way of those who wish to return home from
the island. The writer's conclusion is, that the
chances of recovery for a consumptive are far better
at home, surrounded by the conveniences and com-
forts of life, than in Madeira, where the only favor-
able condition is the climate, and where even that
advantage is more than balanced by the storms of
the spring season.
Artificial Light. — The injurious effect of ar-
tificial light upon the eye is said to be due to the
presence of an excessive number of non-luminous
heat-rays. As proving this, it is said that while
sunlight contains fifty per cent, of these rays, elec-
tric light has eighty, gaslight ninety, and kerosene-
light ninety-four per cent. In view of these facts,
an eminent German chemist proposes to absorb
these injurious rays by interposing between the
source of light and the eye a thin layer of alum or
mica.
Extract from Hering's Analytical Therapeutics. —
Paronychia, Panaritium. — Runaround, Whit-
low, Felon. The most valuable remedies are Apis.,
Hepar S., Natr. Sulph., Silicea, Sulphur. Next in
value are, Fluoric ac, Sepia. Following these are,
Arsenicum, Calc. ostr., Causticum, Graph., Lache-
sis, Malv. rot. Mercur., Nitr. ac, Pulsat., Rhus,
tox., Stramonium. The remaining remedies men-
tioned are of nearly equal value.
Often epidemic; then the medicine correspond-
ing to the predominating character of the weather
and all other prevailing diseases, ought to be given
by preference.
The sooner the first formed blisters are opened or
squeezed, the longer the cases last, becoming al-
ways tedious ; ought never to be lanced. If open-
ed, keep the air off, or have it filtered through cotton.
Runaround. — Superficial subcutaneous : Cepa. ,
Mercur., Rhus., Apis, Graphit., Sulph. Pale
superficial runarounds : Caustic. 6 (low in water ex-
ternally. ) GOULLON.
Lympathic vessels inflamed: Cepa., Lachesis,
Hep. s. c, Sinap., Rhus.
Panaritium Diffusum. — Deeper seated iBryon.,
Hepar., Lycop., Rhus.
Whitlow. — Affecting tendons or aponeurotic tis-
sues: Graphit., Lachesis, Mercur., Sulph., Rhus.,
Hepar., Ledum., Natr. sulph., Ran. bulb., Silic,
Sulphur.
Felon. — Periosteum and bones: Silic, Fluor,
ac, Calc. phosph., Mezer., Sulphur.
Old maltreated cases: Hepar \, Silic, Sulph.,
Phosph., Stramon. — Malv. rot. Jeanes.
In the Beginning, one dose of Sulphur high
may cure the whole, followed by Apis low.
From a hurt : Ledum. From hard work : Rhus.,
Sep. From a prick with a needle under the nail :
Cepa., Bovist., Sulph. From a prick near the nail:
J odium. From, splinters : Baryt., Jod., Sil., Hep.,
Lach., Nitr. ac, Petrol., Sulphur.
From Hangnails. — Lycop., Natr. mur., Sulph.
From splits of the skin adhering to the nail: Cepa.,
Natr. mur.
Beginning at the ROOT OF nails : Caust., Graph.,
Before suppuration: Hepar., Lach.; after: Sil.,
Sulph. Margin of nails: Lithium. Under the nails :
Alum., Caust., Cocc cact., Sulph. All around the
nails: Alum., Bufo., Caust., Crot., Plumb., Hep.,
Lach., Merc, Paris., Puis., Ran. bulb., Ruta,
Sanguin., Ferr. magn.
Points of fingers swollen and hot: Sepia, Sulph.,
Amm. mur., Phosph., Sil., Mar. ver. ; whole fin-
gers with spreading blisters : Magn. curb.
Thumb: Amm. mur., Borax, Bufo., Cepa.,
Eugen., Fluor., Granat., Kali, c, Kali, hydr., Se-
pia, Sulph. Index finger : Sulph. On several fin-
gers : Natr. sulph. From one to the next : San-
guin.
A red line from the hand up to the elbow : Cepa.
Red streaks, swelling, pain up into the armpit:
Bufo., Rhus., Sinap./ with painful swelling of a
gland in axilla: Mecr., Hepar., Silic.
Pains, drawing, tearing : Sepia, Sil. ; as if the
The Medical Union.
239
thumb nail was torn out : Kali. hydr. / shooting :
Asa/., Bryon., Puis., Rhus.; throbbing: Merc,
Silic, Hepar.; boring: Sulph.; throbbing, shoot-
ing: Sep. ; throbbing, burning: Con.; under
thumbnail: Amm. mur.; burning, stinging: Apis;
burning, shooting, repeating now and then ; Fluor,
ac; ulcerating, festering: Berb., Con., Caust.;
very sensitive to touch : Apis, Sanguin., Sulph.;
bursting: Caust.; deep seated : Si/,, Merc; intol-
erable, violent: Lack., Siiic, Stram.
Color, pale red: Bryon., Caust.; livid: Gra-
nat.; yellow shining : Sulph.; light red: Hepar.,
Merc, Sulph., Natr. sulph,; deep red: Rhus-
tox., Lycop, Sepia; dark bluish: Lach., Sassap.,
Sepia; blue black around the thumb nail : Bufo.
Suppuration slow : under the thumb nail : Bo-
rax, Merc, Hepar., Phosph. ; insufficient: Sil.,
Calc {Lach. every two hours, saves the knife —
Kreussler); too copious: Fluor, ac, Sepia.
Proud flesh: Sil, Sacch. off., Lach., Ars.,
Petrol., Graph., Sulph.; a sykotic fungus : Caust.
6 externally ; pale red, spongious, sensitive to touch,
easily bleeding, grows out of an opened felon,
Thuya.
Gangrenous spots: Rhus., Bell., Nux.; pur-
plish blue: Lach.; blackish and burning : Arsen.;
blackish blisters :Ars.; putrid ichor: Asa/., Carb.
veg.; sloughing and burning : Anthrac
With caries, necrosis: Sil., Fluor., Asa/.,
Mezer., Lycop., Aurum., Merc, Ph. ac, Sulph.
Misformed nails are replaced by healthy ones :
Sulph., Sepia.
Maltreated by lancing: Phosph., Silic, Staph. ;
pains following: Hyper. After the abuse of sul-
phur; Apis; of mercury: Lach.; of metals: He-
par.; of sarsaparilla : Sepia.
If Apis is insufficient, give Sulphur high. Wolf.
If Arsenic: Anthrac. Raue. IfMercur. : Hepar,
If Hepar : Lachesis. If Silicea : Fluor. C. Hg.
Felons may be checked in the beginning, before
suppuration, by Nitr. ac. in water, applied locally,
but it is often very painful. To prevent returns,
Calcar. ostr. may be given.
Dioscorea 15 prevented and removed ordinary
whitlow. Bell.
Natr. sulph. After living in damp dwellings
or work-shops ; pale appearance ; tired in the morn-
ing, with a dull head ; loss of appetite ; chilly and
feverish in the evening. A blister on the ungular
phalanx, followed by a deep red swelling, festering
at root of nail, great pains, more bearable out-doors
than in the room. Grauvogl. Corroborated by
Raue. Quick relief and cure after 2C. Bell.
Bryonia. Light pale red ; diffused not hard nor
burning ; at its height tearing, shooting ; if suppu-
rating, the redness spreads more and more ; in the
beginning cold application pleasant, later hot moist
poultices agreeable; dry mouth without thirst, or
great thirst ; bitter taste ; tongue coated ; dry hard
stool; red urine; dry skin; fast frequent strong
pulse. Schelling.
Rhus-tox. Runaround with red streaks or swel-
ling ; pain up into armpit. Or after general com-
plaints, rheumatic on beginning to move; limbs
going to sleep, easily tired, sweating. Guernsey.
Slow local development, frequent remissions. Dark
red, erysipelas-like with little blisters, often with
oedema, In corresponding cases the blisters may
even be virulent blackish. Schelling. From
chilblains: Rhus, Gaspary.
Lycop. Extending over the whole hand, dark
red with many complaints indicating it ; belching,
bloated belly; pressing, etc., under short ribs, burn-
ing and nausea ; emptiness in stomach with yawn-
ing, etc. Schelling.
Sepia. With such as have tetters ; felon chang-
ing hands; throbbing, shooting pain, sleepless.
Every evening 6. Gaspary.
Graphites. Superficial inflammation mostly on
the root of nail ; violent burning, throbbing, then
suppuration, after open proud flesh. In the begin-
ning it ends the whole within a few hours. Kreus-
sler.
- Hepar S. C. Superficial erysipelatous onychia
around the root of nail. Before suppuration ; after
it: Lachesis. Jahr. Thumb livid, most violent
throbbing, cutting, burning pain. Promotes sup-
puration, particularly after metallic influences. C.
Hg. 1828. Last joint hard, red and swollen, lym-
phatics inflamed, lump in axilla : Hepar 3, inter-
nally and externally. Newton. Subject to it every
winter for some years : Hepar s. c, same way.
Newton. Sensitiveness to touch and cold. Hills.
Mercur. More throbbing than shooting, not
violent pain. Eidherr. Inflamed in the cellular
tissue beneath the cutis on the sinews, their fasciae
and the phalangial joints. Kreussler. Extreme-
ly sensitive to heat and cold. Hills.
Silic. Not much swelling, moderate redness
and heat, but periosteum affected. Deep-seated in-
flammation, violent shooting pain, deep in the fin-
ger, worse in the warm bed : sleepless nightly; loss
of appetite ; nausea even to fainting ; pains often
unbearable with bodily restlessness; irritability
even to convulsive jerks. Opening with a surround-
ing wall of proud flesh, pus malignant discolored.
Promotes expulsion of necrotic bones. Seidel.
Violent nightly pains threatening necrosis :
Asa/. 2°. Bell. Necrosis of tendon, dark discol-
oration : Lachesis 20 and 4im. Bell.
A case of month's duration with a shoemaker,
phalanx of thumb necrotic, improved soon and got
well, while smelling at every aggravation of pain :
Sil. or Hepar in alternation. C. Hg.
Chenopodium bonus Henricus; Blue water flag-
root; Juncuseffusus; Juncus pilosus, popular reme-
dies in felons.
Atropia in Opium Poisoning. — Dr. Daniel S.
Bucklin, Lansingburg, N. Y. {N. Y. Medical Jour-
nal) records two cases of opium poisoning, success-
fully treated by atropia. He ordered Fleming's solu-
tion of atropia in ten minim (20 drops) doses.
Uews 3tem$*
The International Medical Congress has
met this year in Vienna. The session commenced
on Sept. 1, with a speech by the Archduke Rainer,
in which His Imperial Highness welcomed the visi-
tors to Vienna. The chair was taken by professor
Rokitansky as president, who delivered an address.
Special discussions afterwards took place on sub-
jects of sanitary and general professional interest,
viz. : vaccination, the prevention of syphilis and the
control of prostitution ; quarantine in general, and
in its application to cholera; the formation of an
international pharmacopoeia ; the drainage of
240
The Medical Uniofi,
towns ; and the social position of the medical pro-
fession. It is somewhat remarkable in the consti-
tution of this congress that, though it bore the
name of international, and several of its members
were accredited to it by the governments and learn-
ed societies of their respective countries, there ap-
pears to have been a deficiency of representatives
from some countries — notably England and Swe-
den. The next meeting is to be held in Brussels
in 1875.
Dr. Fr. Erman (Berliner Klinische Wochens-
chrift, Aug. 25, 1873), gives the results of tempera-
ture observations in about thirty cases of cholera
recently admitted into the general hospital at Ham-
burg. The results are very remarkable, in so far
as they show in the majority of cases a febrile eleva-
tion of temperature during the stage of collapse.
In the first twenty-five cases admitted, all without
exception presented an elevation of temperature,
ranging in different cases from 38 to 40, and
even 42 Centigrade, that is, from 100.4 to 107.6
Fahr.
The oldest lunatic asylum in America is at
Williamsburgh, Va. It was opened October 12,
I773- There is but one institution of the kind in
Europe older than this.
During the late war Dr. , entering the hos-
pital surgery, met Paddy Doyle, the orderly, and
asked him which he considered the most danger-
ous of the many cases then in the hospital. " That,
sir," said Paddy, as, with an indicative jerk of the
thumb, he pointed to where, on the table, lay a
case of surgical instruments.
A Fine property in Chester Co., Penn., for sale
cheap, on easy terms. Has been occupied by
physicans for forty years. A first rate opportunity
for a Homoeopathic Physician ; none other within
a radius of six miles. For further particulars, call
on or address W. B. Newlin, Room 34, Trinity
Building, New York city.
Yellow Fever. — Shreveport, La., in the latter
part of August, was visited with a malignant type
of yellow fever. The place was destitute of sanitary
regulations, and its spread was very rapid. On the
19th Sept. the population, by deaths and removals,
had been reduced from 5,000 to 3,000, and of this
number it was estimated 1,000 were sick or conva-
lescent. Telegraph operators had all died, and
their places, as well as physicians and nurses, had
to be supplied from New Orleans. The disease is
now decreasing from lack of material. On Sept.
14, the Board of Health of Memphis announced that
the disease was in that city. The authorities com-
menced burning coal tar in the infected locality on
the following day. The disease is of a milder type
than in Shreveport.
The Michigan University has matriculated
eighty-eight girls for the coming year, thirty-seven
of them being in the medical department.
Voltaire's Definition of a Physician is
"An unfortunate gentleman expected every day to
perform a miracle, namely, to reconcile health with
intemperance."
Dr. Auguste Nelaton. — Dr. Nelaton, the cele-
brated French surgeon, died recently in Paris, at
the age of eighty-seven years. He was distinguish-
ed as a writer and teacher, and was created success-
ively, Surgeon of the Hospitals, Fellow of the Faculty
of Medicine, Professor of Clinical Surgery, and
Honorary Professor. He was appointed Surgeon
to the Emperor in 1866, Grand Officer of the Legion
of Honor in 1867, and Senator in 1868. The va-
rious treatises he has written have been considered
standard authorities upon the subjects of which they
treated. The Nelaton probe was constructed to
find the bullet in the foot of Garibaldi, after the
battle of Aspromonte. Contrary to the opinions of
the most eminent surgeons of England and France,
he insisted that the bullet was in the foot, and with
this probe discovered its locality, from whence it
was removed by an operation.
Medical Congress at Vienna. — At the Medi-
cal Congress recently held, at which representatives
from almost every country in Europe, as well as the
United States, were present, the subject of vaccina-
tion formed an important topic of discussion. Dr.
Neuman stated that in small-pox epidemics mor-
tality is notoriously five times greater with those
who have not been vaccinated than with those who
have been vaccinated. During the last epidemic in
Berlin, forty per cent, of the non-vaccinated, and
two of the vaccinated, died.
The following resolution, introduced by Professor
Hebra, was passed, one hundred and fifty-five out
of one hundred and sixty-two ballots being in the
affirmative :
"The third International Medical Congress de-
clares the cow-pox vaccination necessary, and re-
commends to the respective governments the intro-
duction of obligatory vaccination."
Dr. Otto Obermier. — The Berlin medical
journals record the death of Dr. Obermier, of chol-
era, at the age of thirty-one. Within the last few
months he published some interesting researches in
the blood of typhus fever, and when seized with his
fatal illness was engaged in researches on cholera.
Having too great confidence in his power of resist-
ing infection, in consequence of not having taken
fever during his investigations of that disease, he
kept in his bedroom pathological specimens taken
from persons who had died from cholera, and it is
believed that in this way he became infected. Ac-
cording to one account, he injected some blood from
cholera patients into his own veins. He was so de-
voted to his enquiry that after he had become
aware of the condition in which he was, he made
some microscopic examinations of his own blood.
A like courage displayed on the battle field, in the
destruction of human life instead of its salvation,
would have immortalized him as one of the heroes
which history loves to honor.
Professor Gegenbauer, of Jena, the well-known
comparative anatomist, has been nominated Profes-
sor of Anatomy, and Director of the Anatomical In-
stitute in the University of Heidelberg.
M. Lebarre has made the discovery that hydro-
gen is not an element, but consists of two elements,
one of which is nine times as light as hydrogen.
The new element is called abaron, that is, the j
weightless. It will not burn, extinguishes flames,
and is without odor, taste, or color. The discoverer
recently explained his discovery, and the experi-
ments by which he had eliminated it, to the Acad-
emy of Sciences, Paris, in secret session.
The Medical Union,
241
iDrtginal Articles,
PUERPERAL CONVULSIONS.
By Egbert Guernsey, M. D.
It is seldom the sympathies of the physician are so
strongly enlisted as in those fearful convulsions
which occur during the last months of pregnancy,
and in the process of and shortly following labor.
The utterly helpless condition of his patient, and
the fact that the convulsions are the result of the
changes which have taken place in her blood, and
their effect upon the nerve centres, through the
growth of the child or the shock upon the nervous
system attending its birth, invests the case with the
gravest responsibilities, and call into action all the
skill and sympathy of the attending physician.
Females are particularly liable to convulsions,
owing to their delicate organizations, and highly
impressible nervous temperaments at different
stages of their lives. Convulsions in infancy,
where they do not arise from any organic changes in
the physical structure, but are due more particu-
larly to an excitable nervous temperament, or reflex
action, notwithstanding, they are common to both
sexes, are much more frequent among females.
Again, as the child passes through the stage of pu-
berty, and emerges from childhood into woman-
hood, there is often a strong tendency to convulsions,
which may last during the entire period of menstru-
ation. The severe menstrual pains, the result,
sometimes, of deranged circulation, acting upon a
highly impressible and easily excited nervous organ-
ization, are enough in many cases to produce more or
less severe convulsions. This excitable condition of
the nervous system may give rise during pregnancy,
and at the time of labor, to hysterical convulsions, or
even where there has been a tendency to epilepsy,
that trouble may be developed ; but these cases are
easily diagnosed, and generally amenable to treat-
ment and need create but little alarm.
It is to those graver forms of convulsions occur-
ring during the last months of pregnancy, and dur-
ing, and shortly after labor, to % which the name of
eclampsia has been given, that our attention will be
directed in this article.
We must, at starting, take into consideration the
change which in a greater or less degree must
take place in the circulation and the nutrition of the
mother during the development of this new life
and the growth in all its parts, absorbing the ma-
terial from the mother of this new and complete
physical organization — this life within a life ; the
one drawing its support and strength from the
other. Thus the heart, to supply the uterus and
the rapidly growing embryo, is obliged to beat more
powerfully and with greater frequency, producing,
for the time, a normal hypertrophy. There is an
altered condition also in the blood itself, indicated
by the decrease of the red globules, the increase of
)the white globules and an excess of fibrin and
water; and in connection with this an increased
amount of material to be excreted, so that often the
liver and kidneys are taxed beyond their power.
The uterus, also, as it increases in size, may press
upon the larger blood-vessels in such a way as to
produce more or less nephritic trouble. Thus we
have, all conspiring to produce albuminuria, the
altered, condition of the blood, the increased action
of the heart/ the overtaxed liver and kidneys, and
lastly, the nephritic congestion produced by mechan-
ical causes.
In no case, except, perhaps, following scarlatina
and diphtheria, does albuminuria advance so rapidly,
and we can trace its successive stages so clearly, as
in pregnancy. The question naturally arises if the
convulsions are due solely to albuminuria, why
do they occur so much more frequently in preg-
nancy than in scarlatina, diphtheria, and acute
Bright's disease, when the albuminuria is often
greater ? The primary cause is undoubtedly a fail-
ure of the kidneys to perform their normal functions,
and the consequent accumulation in the system of
the poisonous elements which would otherwise be
eliminated by the urine. This poisonous agent,
undoubtedly, whatever it may be, acts upon the
cerebro-spinal centres, increasing the irritability of
the nervous system, and rendering the patient liable
to convulsions. Very slight causes where this
poisoned condition of the blood exists may arouse the
dormant energies of the cerebro-spinal axis to such
an extent as to produce convulsions. Thus, in this
condition, the patient is constantly threatened with
premature labor or eclampsia.
Early investigators attributed the symptoms of
uremia to retained urea. Some years ago, Frerichs
brought forward the opinion that as he was unable
to demonstrate the presence of urea in the blood,
the urea was probably converted into carbonate of am-
monia, and as such, exerted its deleterious influence.
Halbertsmer believes that eclampsia is generally
caused by retention of some of the constituents of
the urine, and this retention is due not always to
primary disease of the kidneys, for recent post-
mortem examinations show cases where the kidneys
were not diseased at all, but to the pressure of the
uterus upon the ureters.
Still later, Traube has given an explanation which
has excited considerable attention. He believes
that the loss of albumen leaves the blood-serum
in such an impoverished condition that there is a
tendency to transude, and in consequence of hy-
pertrophy of the left ventricle of the heart, the blood-
pressure in the arterial system is increased. When,
as the trouble progresses, the density of the blood-
serum is still further diminished and the blood-
pressure suddenly increased, bloody serum trans-
udes through the small arteries, and oedema of
the 'brain is the result. The capillaries and veins
are compressed and the brain becomes correspond-
ingly anaemic. If the cerebrum alone is involved,
coma appears; if the pons variola and medulla
oblongata alone, convulsions ; if both together be
affected we get both coma and convulsions. Usually,
the case commences with convulsions, passing
speedily into coma, which becomes profound, or is
only broken by the returning convulsion. Oppler,
from careful experiments, believes that urea is
formed in the kidneys from the nitrogenous mate-
rials in the blood, and that the ufemic conditions
depend upon the accumulation in the blood of
creatin and creatinin. These experiments have
been confirmed by many other investigators. Op-
pler also states that there is a retention of
muscle-waste in cases of uremia, and thought that
there misrht be also a retention of the products of
242
The Medical Union.
the nerve-waste, to which might be ascribed the
symptoms. What, then, are the causes, as nearly as
can be ascertained by the most careful experiments
and physiological investigations, of puerperal convul-
sions ?
Accumulated irritability of the nervous centres, the
product of the altered state of nutrition induced in
them by pregnancy. This change in the altered
state of the blood is induced by a partial arrest of
the urinary secretion, so that the urea is retained in
the circulation. Careful analysis shows that urea is
the only poisonous ingredient in the urine, and that
it is the united product of all nitrogenized effete
matter, and experiments show that when introduced
into the blood of animals it acts as a narcotic poison,
producing all the symptoms of uremia. Whatever
the cause, then, of the formation of the poison, we
are convinced that it has much to do with the grave
symptoms which we see developed in uremia. Act-
ing primarily upon the cerebro-spinal centres, it so
interferes with the functions of organic life as to pro-
duce the oedema of the brain and those structural
changes we detect in this disease.
In diagnosing this terrible disease, we have four
points to take into careful consideration. Either
of the three first conditions may exist in pregnancy
and labor, and the last immediately following labor :
I. — Hysteria. 2. — Epilepsy. 3. — Eclampsia. 4.
— Embolism.
1. It is not always easy to distinguish a parox-
ysm of hysteria from one of epilepsy, yet to
the careful observer there are well-marked points
of difference to ensure a correct diagnosis. In
hysteria, the loss of consciousness is gradual and
apparent, or only partial. In epilepsy, it is sudden
and complete. In hysteria there is no froth on the
lips, the eyelids are closed and the eyeballs are
fixed ; there is no grinding of the teeth and biting
of the tongue, and the pupils react. In epilepsy
there is an escape of frothy saliva from the mouth,
the eyelids are half open and the eyeballs rolling,
there is grinding of the teeth, biting of the tongue
and insensibility of the pupils to light.
The case once accurately diagnosed, the subse-
quent treatment is simple. First, the removal of
every cause, except, of course, the pregnant condi-
tion itself, which would have a tendency to excite the
nervous system. A careful study of the food and
particular attention to the bowels are, of course,
requisite. Exercise in the open air, pleasant and
cheerful society, and all those external surroundings
which would have a tendency to equalize the
nervous system, are essential.
Some years since,. I attended a lady in confine-
ment with her third child. She was not generally
of a very nervous temperament, but at this time her
nervous strength had been taxed by sickness of her
children and the inefficiency of servants. On the
third day she was attacked with a violent convulsion,
which had passed over, however, when I saw her.
As near as I could make out, from her husband, the
symptoms were those of an epileptic character, but
her previous history showed no trace of this disease.
A careful examination of her water showed an abun-
dance of phosphates but no trace of albumen. The
attack was, undoubtedly, one of hysteria, brought
on "by nervous excitement acting upon a nervous
system weakened by worry and fatigue. I placed
her upon the use of phosphoric acid as a nerve food,
giving her fifteen drops of the dilute three times a
day, and of zizia. The next day she had another
slight convulsion, from which time the convales-
cence progressed rapidly and favorably, the action
of the zizia being very apparent in quieting the
nervous system. And, in this connection, I have
one word to say in reference to this, by some much-
vaunted drug in eclampsia. In my hands, and I
have given it a pretty fair test, it is entirely useless
in that disease, and only of benefit in the hysterical
forms of trouble, where its action is often exceed-
ingly brilliant. Among the other remedies are —
Nux., Ignatia, Platina, Pulsatilla, Assafcetida, etc.
2. Epilepsy, —Epileptic and uremic convulsions
so much resemble each other that it is sometimes
difficult to distinguish them except by taking into
consideration the previous history of the case and a
careful examination of the urine. The excitement
of labor, the intense agony of delivery, will some-
times produce a distinct epileptic convulsion, even
when there has been no previous attack. In epi-
lepsy one side is more convulsed than the other,
while in uremia both sides are alike convulsed.
Following an epileptic attack, there is deep sleep,
from which the patient can be aroused, but the
uremic paroxysm is followed by deep coma, and
the first attack is generally speedily followed by a
second and a third. With these differential symp-
toms, together with the previous history of the case,
and a careful examination of the urine, the physi-
cian is able to reach a correct diagnosis.
Case i. — I was summoned in great haste to see a
lady in her seventh month, and as I was told, in
violent convulsions. Owing to her extreme nervous
temperament and her liability to convulsions, I had
watched the progress of this, her first pregnancy,
with a great deal of care. The day before, I had
carefully examined her water, and found in it noth-
ing abnormal. The existing cause, it seemed to
me, was the stomach; and learning she had just
taken a large dish of oysters, as soon as she was able
to swallow I gave her a glass of tepid water with a
little dash of mustard in it. In a few moments a
large quantity of oysters were thrown up, and the
trouble was over. She said, in eating the oysters
she thought they were not very fresh. She reached
her full time without any further trouble. The la-
bor was natural and progressed finely, but bearing
in mind her previous history I thought it best to go
to my office for my forceps in anticipation of any
trouble. I was not absent more than fifteen minutes,
but when I returned I found her violently convulsed.
I at once applied the forceps, and as soon as the
after-birth were delivered all convulsive movements
ceased, and she made a rapid recovery.
Case 2. — On reaching my office late one after-
noon, I found a message left two hours before, to
come at once to Mrs. L., who was in convulsions.
My nephew, Dr. Wm. N. Guernsey, was in the office
a few moments after the message was left, and hast-
ened at once to the house. He found the patient at
full time, violently convulsed, and as shown by an
examination, in labor. Ascertaining from inquiry
her previous liability to convulsions, noticing the ab-
sence of oedema, he at once diagnosed the case as
epilepsy induced by labor, and immediately pro-
ceeded to expedite the delivery ofrithe child. Quiet-
ing the spasms with chloroform, he ruptured
the membrane, and by the continued pres-
sure of his fingers proceeded to dilate the par-
tially rigid os. When this was sufficiently accom-
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243
)
plished to introduce the blades of the forceps, the
patient was brought completely under the influence
of chloroform and the child safely delivered. When
I reached the house I found the child in the nurse's
arms and the mother coming back to consciousness.
She made a speedy recovery. Thanks to the quick-
ness of diagnosis and prompt action, the life of the
child, and possibly that of the mother also, was
saved.
3. Eclampsia. — As I have said, an attack of
eclampsia resembles closely, in its immediate symp-
toms, epilepsy ; but it is generally preceded by
well-marked symptoms, such as oedema, usually of
the extremities and sometimes of the whole body,
headache, dizziness, impaired vision and a great de-
sire to sleep. Examination of the urine now re-
veals well-marked albuminuria, and admonishes the
physician of the danger ahead. When the attack
comes on in light cases, it may be confined to a
single convulsion, followed by a period of insensi-
bility ; or, if the elimination of the poison by the
kidneys has been interrupted to such an extent that
a large amount of urea is retained in the circula-
tion, one convulsion follows another with more or
less rapidity, the insensibility becoming more or less
profound, until the patient passes into complete
coma. The pulse during the convulsions is accele-
rated and the thermometer frequently marks 107.
Uremic coma sometimes comes on almost from the
first, but usually not until later on in the attack.
As it develops itself, you notice the heavy stertorous
breathing, the respirations generally becoming slow
and labored ; the pupil is dilated and takes no im-
pression of the bright light flashed before it ; the
pulse loses its firmness, and the temperature, with
the waning vitality, sinks below its normal' standard.
Uremic coma may be distinguished from cerebral
apoplexy by the absence of paralysis, which in the
latter sets in with the convulsions in the form of facial
paralysis and hemiplegia, the coma preceding the
convulsive attack. In poisoning from opium the
temperature at once sinks below the normal stand-
ard, while in uremic coma it is at first above one
hundred, and not until the last, as vitality is dimin-
ished, sinks below the natural condition.
The setting in of labor may be the immediate
cause of convulsions. The nerve centres, already
feeling the effect of the uremic poison, may be ex-
cited into activity by uterine action. We often notice
the first fit following the dilation of the cervix.
After a fit there is a period of calm, marked usually
by more or less coma. Presently, we see indications
of another convulsion; placing the hand over the
womb we can feel it contracting, showing that the
contraction of the womb excites the convulsion .
At other times, and more frequently, the convul-
sions precede labor, the labor being induced by the
circulation of blood charged with excess of carbonic
acid. Such blood Brown-Sequard has shown to be
a direct stimulant of muscular action. I have often
noticed the os, rigid at the first attack, gradually re-
lax as one convulsion followed another, and the
womb give evidence, as the hand was placed over
the abdomen, of strong contraction.
\ Treatment. — We pass now to the consideration of
^the treatment ; and here we shall always do well to
bear in mind the cause and pathology of the disease.
I think it is safe to lay down the rule that where
well-marked eclampsia occurs in the latter part of
pregnancy, as it almost always does "if it occurs at
all, to bring on labor promptly and deliver the foetus.
The patient might, it is true, pass on to the full
term and be delivered in safety, but in nineteen
cases out of twenty, either before or at the full term,
convulsions would again return with such violence
as to render all effort at relief unavailing. If there
is evidence of much uremic poisoning, the patient
should be placed under chloroform, and if the con-
vulsions follow each other in rapid succession, and
the danger is imminent, the delivery should be
hastened by mechanical dilatation, and the use of
the forceps. Sometimes opium acts better than
chloroform, and its effects are usually followed by
speedy delivery. On the theory of Traube, some
writers have recommended venesection, believing a
sudden depletion of the vascular system, by which the
pressure is diminished, must stop the attacks.
But experience shows us that even upon this theory
blood-letting is not by any means a sure remedy,
for in a short time after venesection the quantity of
blood becomes the same through the serum taken
from all the tissues, but the quality is greatly deteri-
orated. In light cases this sudden lifting of the
pressure may produce relief; but when the violent
convulsions show severe uremic poisoning, the prob-
abilities are, with the return of that pressure, which
must be in a short time, the attacks will return with
more danger to the patient, because the quality of
blood has been deteriorated by abstraction, and the
strength of the patient wasted. In our treatment
the attention, as I have said, should be directed to
the cause of the trouble : the failure of the kidneys
and skin to eliminate the poison, and its peculiar
action upon the nerve centres. That class of diu-
retics which have a tendency to directly stimulate
the kidneys are, of course, in their present condition,
not admissible. But in our school we have a class
of remedies which, acting powerfully, though not
with violence, upon the nerve centres, rouse into ac-
tion the venous and arterial capillaries, and the great
excreting organs — the skin, the kidneys and liver
— facilitating the elimination of poison with more
certainty than those violent remedies whose force
is soon spent, and if not successful leave the sys-
tem in a worse condition than before. Among the
remedies most used in our school, some of which
we shall speak of in our clinical cases, we may
mention Opium, Belladonna, Apis, Digitalis,
Aconite, and Arsenicum, Mercurius, and Hello-
nias.
The action of chloroform is, we think, merely
palliative, but in the early stages it moderates the
paroxysms, giving us time for the employment of
more certain curative agents. Dr. Roberts says
that during the convulsive paroxysm, chloroform
inhalation is the most prompt and ready means of
controlling the spasm ; when, however, uremic
paroxysms begin with drowsiness and gradually pass
on to insensibility, or when convulsions occur as
breaks in a continually comatose condition, chloro-
form affords no prospect of relief. This statement
coincides with our own experience. The length of
this article admonishes us that we must speedily
draw it to a close, which we shall do after narrating
a few clinical cases illustrating the various phases
of the disease.
Case i. — Mrs. C , after the birth of her first
child, residing in the country, had a severe attack
of rheumatism, which left its traces in organic trou-
bles of the heart. I was sent for in the seventh
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month of pregnancy and found a general dropsical
condition, oppressed breathing, impaired vision,
dizziness, and constant desire to sleep. The urine was
heavily loaded with albumen. The case seemed so
urgent, that I ordered the bowels to be opened with
an enema preparatory to bringing on labor. Return-
ing in half an hour, I found her in a convulsion
and labor already commenced. I proceeded to rup-
ture the membranes, and, administering chloroform,
the labor was speedily and safely accomplished by
the birth of a living child. There was no return of
the paroxysm, and under the use of Digitalis and
Mercurius, and afterward of Arsenicum, the trouble
soon disappeared. The child was given to a wet
nurse and did well. Two years after, at the seventh
month, under similar circumstances, I again brought
on labor with like results. The Digitalis was given
in eight or ten drop doses, or one-fourth to one-
third of a grain of the powdered drug.
Case 2. — Mrs. F , at the sixth month, was
seized with a severe convulsion. The urine was
highly albuminous. Hoping to carry her along un-
til the seventh month, so as to give a chance of sav-
ing the child, after the convulsion (of which there
was but one) had subsided, the dizziness, the impair-
ed vision, and those general symptoms of uremic
poisoning, were treated with the appropriate reme-
dies with apparent good results ; but one month
after, she was seized with a violent convulsion in
her carriage. When I reached her, I found the
deep coma into which she sunk was only broken by
paroxysms of intense and fearful violence. Steps
were immediately taken to bring on delivery as
speedily as possible. The danger seemed so immi-
nent that I requested that my friend Dr. Carnochan
might be called in consultation. In four hours from
the attack, we delivered her of a dead foetus, and in
one hour after she was dead. From the first attack
until the struggling, convulsed limbs were still in
death, there was not one single gleam of conscious-
ness. As I left the chamber of death and the sad
hearts gathered there, and went out into the dark
night, over my own soul swept the crushing thought,
"Perhaps, if one month ago you had delivered that
child, the young mother now sleeping in death
might have been saved."
Case 3. — Several years since, I was called by Dr.
L. T. Warner, at that time associated in practice with
Dr. JohnF. Gray, at about five o'clock in the morn-
ing, to assist him in a case of puerperal convulsions.
The patient was in her eighth month, and about
three o'clock had roused her husband by clutching
him by the arm, and then passed off into a convul-
sion. There was general anasarca, and the water
showed a large amount of albumen. At no time was
there a return of consciousness, the convulsions
following each other in rapid succession, but were at
first very much controlled in severity by chloroform.
At about seven, Dr. Gray bled her freely, hoping
thereby to relieve the pressure upon the brain. For
an hour, perhaps, there was some relief, but then
the attacks returned with increased violence. Un-
der the influence of the convulsions intense contrac-
tions had already commenced, and both Dr. War-
ner and myself felt the necessity of expediting de-
livery as rapidly as possible. At eight Dr. Warner
was obliged to leave, to fulfill an important engage-
ment out of town, and the case was left in my
hands. She was now unable to take anything by
the mouth, and the convulsions were only slightly
controlled by chloroform. In a few hours the
womb was sufficiently dilated to introduce the for-
ceps, and she was delivered of a dead child.
Almost immediately the severity of the convulsions
began to subside, and by evening ceased entirely,
after having had thirty-nine from the commence-
ment of the attack. The next morning there was a
partial return of consciousness, and in a few days, un-
der the influence of careful nursing and the use, as
indicated, of Opium, Arsenicum, and Digitalis, all
danger was over.
Case 4. — As I was about leaving my office for my
morning rounds, I received a telegram from a friend
in a neighboring town, to come up in the two
o'clock train, to see a lady very sick. I replied I
could not come until evening, and did not reach
the place until seven o'clock. My friend met me at
the depot, with the information I was too late, as
the lady was dying. I found her with flushed face,
heavy stertorous breathing, and the pupils entirely
insensible to light. The convulsions were violent
and her pulse weak; she was unable to swallow,
and the attending physician said that chloroform
had ceased to be of any benefit. There was evi-
dence of slight uterine contraction. I proceeded to
rupture the membranes, and then with my fingers
commenced mechanical dilatation. By nine o'clock
I had so far succeeded as to be able to introduce
a small pair of long forceps, and after a good deal
of effort bringing away the foetus. The convulsions
now rapidly subsided, and in the morning there
was a partial return of consciousness. I was informed
by the attending physician that her recovery was
slow, but at length complete. One year after,
I saw her death in the paper, and learned she had
died in her second confinement in uremic convulsions.
Case 5. — Mrs. M , sixth month, urine highly al-
buminous, and convulsions of great violence. Labor
had already commenced, but the convulsions were
so violent in their character as to lead me to fear
the immediate result. Chloroform seemed to in-
crease the violence of the attack, and I determined
to administer Morphine hyperdermically. A quar-
ter of a grain was injected into the arm. In a few
moments the breathing became heavier; but this
gradually quieted, so that in half an hour she was
breathing quietly and easily, and the skin had be-
come moist. In an hour's time I drew off with the
catheter quite a quantity of water, showing the kid-
neys were acting more freely. An hour and a-half
after the injection, fearing a return of the convul-
sions, I again injected a quarter of a grain of Mor-
phine. She remained quiet for four hours, when
labor returned naturally and with considerable
strength. There was no return of the paroxysms
and the labor was completed in an hour. Under
the use of Apis and Arsenicum, the dropsy speedily
subsided and the urine became normal.
I presume, no one has witnessed a severe attack
of eclampsia without recognizing in the appearance
of the patient a picture of Opium poisoning, espe-
cially after it has passed into the stage of coma. Ac-
cording to the law of similia, Opium ought to pro-
duce relief, and because it does not more frequently
do so is, perhaps, owing to the fact that it is not ^
generally given in sufficient strength to produce its
homoeopathic action. Like Quinine, in intermittent
fever, given in minute doses, it is overmastered by the
poison, but its homoeopathic action is fully shown
in doses of from one to two grains.
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245
Many, carrying out the idea of Freish that the
\ urea is decomposed into ammonia — which, we think
is by no means fully proven — give, to produce a
chemical action, the vegetable acids, especially the
acids of lemons and limes. These acids often pro-
duce relief in ordinary forms of albuminuria; but
with us they have failed, where the uremic poison-
ing has produced convulsions.
From the few cases of eclampsia in which we
have used Opium, in decided doses, and from the
experience of others, we are inclined to believe
that this remedy is destined to play an important
part in the treatment of puerperal convulsions.
Embolism. — But one point more remains to be
noticed before concluding this article, already, per-
haps, too long. During labor there is almost
always some abrasion, some point from which a
small clot or particle of fibrin can be taken up, and
swept along by the circulation until it reaches the
brain, causing apoplexy. Thus, the patient may
be doing well, with not a single unpleasant symp-
tom, when suddenly you are startled by a violent
apoplectic attack, for which we have but little power
to afford relief.
Case i. — A lady with her first child passed
through a labor of only ordinary severity, in which
there was even less than the usual amount of hem-
orrhage, with unusual strength and courage.
Nearly an hour had passed, and she was watching,
with a pleasant smile, the dressing of her child,
when I was startled by the contortion of her face
and violent apoplectic seizure. Almost immediately
came on the heavy stertorous breathing, the coma
growing each moment more profound, until, in an
hour's time, she breathed her last. There was no
albuminuria, no uremic poisoning, and the labor
had not been sufficiently violent to produce any
severe nervous shock. It was simply a case of em-
bolism, from which no human foresight could have
guarded her.
I have thus glanced at the different forms of puer-
peral convulsions, illustrating them by my own
experience in cases drawn from practice.
HAMAMELIS IN SECONDARY CEREBRAL
HYPEREMIA.
By Frank A. Rockwith, M. D.
Mrs. Scl l, ast. 24 ; wife of a farmer ; a
blonde, bodily well-developed, had been married two
years without pregnancy; had also been exceed-
ingly irregular in her catamenia, often going six to
seven months without the slightest indication of a
menstrual state. When menstruating, however,
she was rather free, but lasting rarely over two
days. Leucorrhcea had only been noticed after
marriage. A satisfactory anamnesis was almost
impossible to gather, owing to the low social and
educational character of the family. She had been
sick eight weeks, and had been attended by a Ger-
man physician of high repute, and, in fact, a quasi
oracle among the members of the local medical
society (old school). I could gather just sufficient
to know that he had treated her for malarious fever
complicated by pregnancy, and, judging from the
remnant of divers lots of medicines still on the
table, had given opiates as palliatives and quinine
as a tonic ; an unused fly blister, intended for the
spine, was also among the collection.
Having been their family physician some eleven
years ago, I was again called in as a kind of dernier
resort.
A very extensive varicose condition of both the
lower extremities, extending upward to the crest
of the ilium, and forward upon the lower part of the
abdomen, also across the lumbo-sacral regions,
led me to examine the areola of the breasts in
search of evidences for a previous or present preg-
nancy. The mammas, although large, were flabby,
and presented the anomaly of merely rudimentary
nipples. Slight but well-marked axillary varicosis
existed. Her menses had now been suppressed for
over four months, yet neither abdominal taxis nor
the above areolar inspection justified the suspicion of
gestation.
The whole body was in a state of progressive
emaciation, with surface heat, flushed cheeks, glassy
and expressionless eyes, and dilated pupils.
The pulse was small, quick, and easily compres-
sed ; the temperature in the flexed popliteal space
was 980 ; in the closed palm of the hand, 95 p ; in
the axilla, ioo°; in the inside of the cheek, ioo°.
There existed also great tenderness to pressure
along the full extent of the dorsal vertebras, the
pain from handling lasting for a considerable time
after. The ophthalmoscope revealed a retina re-
sembling No. 62, plate xiii, of "Jaeger's Ophthal-
moscop. Hand-Atlas," except that I perceived in the
central vessels the veins more tortuous and the ca-
pillaries more prominent, thus giving to the retina
a darker tint than in the case above, or than is gen-
erally found in blue eyes.
The macula lutea was perhaps more prominent,
although of a more greenish hue. There was also
traceable the beginning of a greenish dark radiation
in place of the granular bottom of normal eyes.
(In psychosis I usually disregard visional examina-
tions and examine the plastic or graphic changes of
the inner eye merely as a diagnostic adjuvant.)
In this somatic investigation I omitted examining
the urine from obvious reasons : First, because the
quantity, color, and general character of that which
I saw offered nothing sufficiently remarkable ; and,
secondly, even though a slight quantity of albumen
should have been present it would not have been of
material importance in this form of psychosis, nor
could a uremic condition exist because of the
evidently secondary character of the cerebral hyper-
emia.
The physical manifestations had been a religious
mania in alternation with outbursts of hilarities, in
which the lascivious expression was prominently
characteristic. Again, there had been fits of anger
against a much-petted brother, whose soul she
thought hopelessly sold to the devil. She was
much inclined to pray, which spells were particu-
larly worse after a visit from the over-pious Luther-
an domine, who himself believed in the demoniacal
possession of the insane. She was inclined to run
away and to change her residence. She was at
this time at the house of her mother, some eight
miles distant from her own home.
The maniacal paroxysms were intermittent, but
irregular in duration, with lucid intervals, equally
uncertain in length. When rational, her conversa-
tion was always attended with semi-idiotic or imbe-
cile laughter, which made it difficult to understand
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her. Her answers were even then vulgar, exagger-
ated, boisterous, and not unmixed with cunning. A
peculiar leering visus sardo7iicus was always pres-
ent, even in repose. But at no time did she fail to
recognize her relatives, friends, or the doctor and
his mission.
I felt satisfied from general conversation regarding
the past, that there had preceded this final outburst
■a. status melanckolicus, that is, a primary psychosis
from strictly cerebral hyperemia, and that at this
time 1 found the patient in that peculiar transition
of the hyperemia into the anaemic condition of the
brain.
Already the symptoms of brightened muscular
activity, of general mental exaltation and the utter
disregard of consequences, foretold the approaching
secondary stage of insanity, and also the prognostic
signs of a paralytic termination and of hopeless
dementia.
I had here a pretty mess of " key-notes," with
plenty of symptoms to choose from ad libitum, and
a materia medica abundantly liberal, with a i ' cura-
tive agent." But as I was already sufficiently deep
in the mud of our boastful materia medica, what
else was I to do but fall back upon, pathology, so
much decried and yet so little appreciated by the
symptomatologists of our school.
Was not the varicosis the sole and only promi-
nent type of the disease, and is not varicosis a
mighty cause for arterial inturgescence ? Hence
secondary cerebral hyperaemia, which in this case
had its highest culmination in the dorso-vertebral
congestion.
All that the low Intelligence of the patient could
give me was unreliable, and hence how to select a
remedy, a la Guernsey's key-notes, I could not well
perceive. Clinical results alone urged upon me the
remedy Hamamelis.
. Yet all the general symptoms for which Hama-
melis has proved curative were missing. We had
no hemorrhages, and hence the key-note that
' ' small wounds bleed freely " was worthless. Neither
had there ever existed hemorrhoids, or even consti-
pation. Nor had we confessed head symptoms, such
as "a crowding fullness in the head," nor "tight-
ness of the bridge of the nose," etc., nor "pricking
pains, increased by pressure."
The assertion of a prover that it has caused in
him "loftiness of thought and sublimeness of con-
ception so as to enable him (an artist) to finish a
sacred historical work of high aim," was neither ver-
batim nor pe se of the least influence in my diagnosis.
I gave her five-drop doses of a saturated tincture,
made by myself from leaves gathered in New Jersey,
every four hours at first, finally every three, and
lastly every six hours.
I ordered a generous nitrogenous diet, light Ger-
man wine, and lukewarm sponge baths daily. After
a week the husband reported to me increasing full-
ness of the varicose blood-vessels, and general mental
improvement without recurring paroxysms, sound
sleep, and total absence of feverishness.
In the fifth week he reported return of menses
lasting over four days.
Some weeks later, great falling out of the hair,
but increasing strength and health.
The great fullness of the varicosed vessels, how-
ever, continues ; so that the question arises whether
this cure of the mental and cerebral symptoms is
likely to prove permanent, or whether, at some
future day, phthisis will not take the place of the
previous brain conditions. V
I have used Hamamelis in the case of old persons
when cardiac stagnation justified the suspicion of
venous inactivity, with happy results. In the case
of a lady in the seventies, with loss of consciousness,
muttering delirium, with anasthesia in injured parts
from a fall, the conditions having lasted for several
days, Hamamelis gave very ready relief.
East Saginaw, Mich.
OBSERVATIONS ON THE TREATMENT OF
COLLES' FRACTURE.
By J. F. Oaks, M. D.
There is no single point of the human skeleton
so frequently the subject of fractures as the lower
end of the radius, except the fracture on the
middle of the clavicle. This fracture has attracted
the attention of many illustrious surgeons, among
whom are Dupuytren, Malgaigne, Voillenier, Goy-
rand, Diday, Ponteau, Colles, R. W. Smith, of
Dublin, Dr. Bond, and, later, Dr. E. M. Moore.
To Dr. Moore is due the honor of giving us the
true pathology of this fracture, and a method of
treatment which results in perfect recovery of the
fracture of the hand.
According to Gross, the result of " treatment is
imperfect recovery of the functions of the hand. "
Holmes, in his admirable work on surgery (vide
page 799, vol. ii), says : "I have found but little
difference in the results of the treatment by the
straight or pistol-shaped splint. There often remains
a swelling on the front of the wrist caused by an in-
durated condition of the sheaths of the tendons."
Now, Prof. Moore has demonstrated, on the
strength of a post-mortem made under very pecu-
liar circumstances, that the above deformity and
swelling at the front of the wrist is due to a luxation
of the ulna — which has escaped the notice of his
colleagues — and that by the reduction of this lux-
ation, and consequent treatment of the complicated
fracture of the radius, the result is a perfect recovery
of all the functions of the hand.
In May, 1869, while an interne at St. Mary's
Hospital, Rochester, N. Y., a female patient, in a
paroxysm of insanity, threw herself from the win-
dow of the third story, striking on the ground with
both hands, producing double Colles' fracture, and
sustained other injuries from which she died in
twenty minutes. Dr. E. M. Moore, the surgeon of
St. Mary's Hospital, made a post-mortem examina-
tion with a view of elucidating the pathology of this
fracture, which had perplexed so many, and is
causing so much discomfort to the large number of
victims of this accident, jj
For the details of this post-mortem examination
I refer the reader to the able article of Prof. Moore
in the Medical Record of 1871, vol. v, page 49.
I will only give a resume of that unique post-
mortem. The shortening of the radius and the
bending of the hand to the radial side of the S
fore-arm was due to the lower fragment being car- V
ried back over the radius, turned toward a rectangu-
lar position and not to impaction.
The swelling on the front of the wrist, and the
gradual sloping off toward the ulna, is due to a
The Medical Union.
247
luxation of the ulna. The internal lateral ligament
and the triangular fibro-cartilage are usually rup-
tured, and when this occurs the posterior annular
ligament is slipped over the head of the ulna and
caught by the styloid process, which brings and
holds the point to the pisiform bone.
By the above resume it is clear to my reader
that we have to deal with a luxation — which is the
most important — and, secondarily, a fracture. Now,
on the correct diagnosis of this luxation depends
a successful treatment of an injury at the wrist-joint.
In " Holmes' Surgery," page 798, vol. ii, we find
the following: "The symptoms of this injury are
so pronounced that it may almost always be recog-
nized at first sight."
Again, on the same page, "It is frequently
months before the hand is free from pain and re-
gains the proper motions, and, too often, an un-
sightly, crooked, and permanently stiff wrist re-
mains, to the great inconvenience of the patient and
the annoyance of the surgeon."
Why should there be so much deformity if a cor-
rect diagnosis has been made ?
It is said it is due to induration of the sheaths of
the tendons, etc.
No, it is due to the willful ignorance and selfish-
ness of the surgeon.
He will not, or cares not to accept or analyze the
experience of his colleagues, when he is well aware
that the results of his treatment are very unsatisfac-
tory.
Prof. Hamilton's success coincides with those of
Gross and Holmes, and many others ; yet, in the
new editions of " Gross' Surgery," and "Hamilton on
Fracture and Dislocation," there is hardly an allusion
made to the array of cases so successfully treated by
my friend and teacher, Prof. Moore. The number
of cases exceed forty, which have been successfully
treated by him ; and I can attest to thirteen while an
interne at St. Mary's Hospital, in which cases re-
covery was as perfect as in fractures at the middle of
the tibia.
It has been my good fortune to treat three cases
at the Brooklyn Homoeopathic Dispensary with the
same result — perfect recovery of the functions of the
hand.
Diagnosis. — The most frequent cause of this in-
jury is a force directly applied to the palmar surface
of the hand by a fall or otherwise. If there be an
arrest of the force before ligamentous rupture, the
difficulty is one of simple (or multiple) fracture of
the radius without the complication of ulnar luxation.
But a force competent to fracture the radius, if
not expended, will generally be able to rupture the
internal lateral ligament and triangular fibro-cartil-
age, displacement of the ulna ensuing : and, if this
force be continued, we way have the next step, which
is a compound luxation, the ulna having been forced
through the integument.
Of this last variety I have seen one case. It oc-
curred in Kimball's tobacco factory, Rochester.
The patient was a young lady, an employee, who
was standing near the press, with her elbow resting
on the table.
I By some accident, the weight became unfastened,
and descended, striking her palm, producing frac-
ture of radius and compound luxation of the ulna.
The styloid process showed the site of the attach-
ment of the internal lateral ligament, which had
been torn away, a few tags only remaining.
In the first variety we have a simple fracture of
the lower end of the radius.
The line fracture is almost always transverse, oc-
casionally it is oblique. It sometimes is multiple.
It is usually situated from one-half inch to one inch
above the articular surface of the bone.
It may also be epiphyseal.
In this fracture there is scarcely any deformity,
and crepitus would undoubtedly be a matter of easy
determination.
A good result from almost any treatment would
also be probable, without any consequent deformity
or disturbance of the functions of the hand.
In the second variety we have a fracture of the
radius, complicated by an ulnar luxation.
This is Moore's fracture, and the treatment, as my
reader must see, will differ from that of the first
variety, inasmuch as we have to deal with a luxa-
tion, which is paramount, and a fracture.
The treatment recommended by Prof. E. M.
Moore is as follows : " The patient may be etherized
or not. An assistant holding the fore-arm of the
patient, the surgeon grasps his hand, the right with
the right, and vice versa; with the other hand placed
under the fore-arm above the fracture, he is enabled
to bring the thumb over the back of the ulna, the
fingers wrapping around the radius.
" Traction is first made by extension, then drawing
the hand laterally to the radial side, then backward,
next keeping it held backward, and while making
(continuing) extension, it is swung toward the ulnar
side, bending well laterally, when the extension of
the hand is changed for flexion, thus describing
nearly a semicircle in circumduction. The position
of the hand grasping the fore-arm undergoes con-
stant change, as it is the antagonist of the other
hand in everything but the extension. As the back-
ward position of the hand, when it is carried to the
extreme ulnar side, is changed to flexion of the
hand, the thumb of the surgeon rolls around the
border of the ulna, and is below when the manoeuvre
is complete.
"The test of reduction is, the presence of the head
of the ulna on the radial side of the ulnar extension.
The head of the ulna rests mediately through the
triangular fibro-cartilage, on the cuneiform bone,
and is restrained from going backward by the an-
nular ligament holding on each side the tendons of
the ext. minimi digiti and the ext. carpi ulnaris,
thus making a concavity corresponding in form to a
socket. When it is pressed into this pocket, and
the hand flexed so that the head is supported by the
wrist, the position of the hand is also restored in its
relation to the radius. As a result of the displace-
ment of the ulna, the ulnar extension is carried from
its place, above the styloid process, to the opposite
side of the ulna in an extreme displacement, but
sometimes remains above its centre.
" To disentangle the styloid and swing the tendon
of the ulnar extensor over into its place, is the pur-
pose of the manoeuvre. The hand is drawn toward
the radius, to pull off (by stretching) the annular
ligament. The backward motion, accompanied with
extension, renders the ulnar extensor tense, which
serves to draw the annular ligament backward.
This is effected by pressing the thumb upon the
ulna. The circumduction carries the tendon over
the side. Its character as a luxation is still further
shown by the fact that the restoration is often ac-
companied by a snap both tangible and audible. If
248
Hie Medical Union.
restored, the retention is effected by a compress and
bandage of adhesive plaster. When the manoeuvre
described has been completed, the hand is flexed,
and the thumb of the surgeon rests on the under
side of the ulna. Its head appears on the back of
the wrist, and corresponds with the opposite arm
in every respect, except the swelling from sanguine-
ous effusion. As in the treatment of any other
luxation, the effort should not be abandoned until
the deformity is removed, and the ulnar extensor in
its place — a fact that can be determined at once."
The dressing I propose is intended to hold the
head of the ulna up in its fascial socket, by bringing
the weight of the hand to bear upon the ulna to
retain it home.
If the thumb of the surgeon is kept under the
ulna after reduction, it will be found that the weight
of the hand is sufficient to keep it in place. As a
substitute for the thumb I place along the ulna,
from the pisiform bo?ie upward, a cylindrical com-
press about two inches in length, and about half an
inch in thickness, — in fact, a single headed roller.
This is placed against the ulna, resting also on
its radial border against the tendon of the flexor
carpi ttlnaris.
A band of adhesive strap of the same width (as
roller) is wrapped firmly around the wrist, and over
the compress, extending downward to the extreme
point of the radius, thus grasping the bones neatly and
tightly. The ordinary rule of loose dressing on the
first visit, to a fracture, is one that I distinctly reject.
I propose to bring all the parts into close relation.
The patient is allowed to cut the bandage along
the back of the wrist in about six hours if the swell-
ing and pain seem to demand it. But I find it is
not often done.
The thickness of the compress raises the adhes-
ive strip so far from the anterior surface of the fore-
arm that strangulation of the vessels does not take
place. Moreover, the compress yields a little
and thus diminishes the pressure. A narow sling
passing under the compress, so as to bring the
weight of the hand to bear upon the ulna, completes
the dressing.
The precaution must be taken that the patient
keep his hand in the same position in the sling dur-
ing the night, as it may result in consecutive luxation.
Again, if this variety of injury present itself to
the surgeon, at various periods remote from the
time of fracture, and when union has taken place,
requiring force for its separation, it will be found
necessary to add weight to the hand and maintain
the treatment for a longer period. The latter is
easily accomplished by an adhesive strap passing
obliquely around the hand and attaching to the
loop ; on the ulnar side, a weight equivalent to half
a pound or more, as may be required. The stand-
ard of time, which has been fully justified by the
results; is fourteen days.
It is desirable that the time be as limited as prac-
ticable, for the following reason :
Motion is a cardinal principle in the treatment of
luxation, and therefore must be insured as early as
possible after ligamentous repair.
It is well to have the patient resume manual la-
bor in moderation immediately after discontinuance
of dressing.
In hospital practice I have found the best exer-
cise to be the washing of dishes, the sweeping of
apartments, and other minor domestic duties.
LARGE FIBROUS TUMOR OF UTERUS TREATED
BY ELECTROLYSIS.
By John Butler, M. D.
MRS. C , aet. 40, a lean, spare woman, sent for
me on May 28th, on account of a profuse uterine
hemorrhage, from which she suffered at intervals
varying from five days to two weeks. I found her
quite anaemic and prostrated, but the flow almost
entirely ceased ; prescribed China 12, promising to
make a uterine examination next day.
May 29th. — Hemorrhage ceased. Found a large
submucous fibroid, about the size of an infant's
head, occupying the upper and anterior part of the
uterus, causing that organ to be anteflexed ; in-
formed the patient of the existence of the tumor,
and suggested treatment by electrolysis, which was
at once consented to.
May 30th. — With the assistance of Dr. Pennoyer
I divided the cervix, after Sims' method, and intro-
duced a sponge tent to effect still further dilatation.
May 3 1 st. — Removed sponge tent, and finding
the os sufficiently dilated, proceeded to operate.
Passing a long, thick platinum needle insulated to
within an inch of the point along my finger into
the uterus, I plunged the needle into the tumor,
about an inch and a-half (the patient being kept un-
der the influence of nitrous oxide), and connected
it (the needle) with the magnetic pole of a zinc and
carbon battery, using thirty cells and completing
the circuit by means of a sponge rheophore placed
over the uterus externally. I allowed this strong
current to pass for ten minutes, and then reduced
the number of cells to eighteen, which I continued to
use for ten minutes more, when I withdrew the needle.
June 1st. — Tumor reduced in size, and very
painful. Considerable abdominal tenderness and
ovaritis; pulse 120; ordered Aconite every two hours.
June 2d. — Tumor still further reduced; less ten-
derness ; pulse 80 ; stopped Aconite.
June 3d. — No fever or tenderness ; large, offen-
sive slough passed from vagina, with considerable
fetid discharge, and some slight hemorrhage.
Evening of June 3d. — I introduced a fresh sponge
tent, to be left in until the following morning.
June 4th. — Removed tent. Tumor smaller.
The vagina being large and lax I had no difficulty
in introducing my hand into it, and my finger into
the uterus. The tumor had become quite soft
and had a large hole in the centre about an inch in
diameter, corresponding to the point where I had
introduced the needle. I then concluded to omit
the use of the needle for the present, so I daily ap-
plied the current from sixteen cells to the uterus,
one electrode on the cervix and the other on the
abdomen, externally.
Tumor steadily decreased in size up to June
30th, when I discontinued treatment.
I examined this patient a few days ago and could
not find even a trace of the tumor, menses normal,
and she says she has increased ten pounds in weight.
98 Lafayette A venue, Brooklyn.
Subcutaneous Injections. — Glycerine is re- \
commended as a dissolvent for subcutaneous injec-
tion. It is neutral, can be easily kept, and is in all
regards the one which approaches the nearest to
the composition of subcutaneous cellular tissue.
The Medical Union.
249
) OPENING ADDRESS BEFORE THE STATE
SCHOOL FOR TRAINING NURSES.
By A. E. Sumner, M. D.
I HAVE the honor of appearing to-night to deliver,
by request of the Medical Board of The Maternity,
the opening lecture of a series before the first class
of the New York State School for Training Nurses.
While I feel great pleasure in complying with their
request, and in anticipating the benefits to be de-
rived from the establishment of this school, I am
not without a keen sense of the responsibilities
which rest upon us in launching a ship that must
be properly steered and carefully handled, in order
that she may escape the many dangers that lie in
her path. That a school of this kind is much need-
ed is beyond question. Physicians have always felt
the need of skillful nurses in the sick chamber ; and
while each physician in a large city has one, two, or
three intelligent attendants upon whom he may
call, still the demand is for an increased number of
skillfully trained and carefully educated nurses. The
good nurse of to-day is a woman of more than aver-
age education, and often one whose sockl position
has been far above that which she occupies. She is
a Christian woman always, for it is impossible for
one to become a faithful attendant upon the sick —
ready and willing, day and night, to attend to the
slightest wants of a patient— without religious prin-
ciples and a kind heart. She appreciates the im-
portance of everything pertaining to the patient.
The room is well ventilated and scrupulously neat
and clean ; the bed always made as comfortable as
possible, and the pillows carefully adjusted; the
food is properly prepared and nicely served. The
medicines are given in strict accordance with the
directions of the attending physicians. She never
speaks unless spoken to, and then encourages the
patient as much as possible. She anticipates every
want, and is full of expedients for comfort. She
assumes entire charge of the patients, but in such
a way as not to seem offensive or officious. In fact,
she does her best to save the patient's life, and is as
much pleased with success as the patient can pos-
sibly be. The nurses described are rare, but they
do exist, and physicians are frequently called upon
to wonder at the devotion, and even heroism, of
these lady assistants. Given a nurse of this de-
scription, and make her familiar with the general
anatomy of the body, the management and mechan-
ism of labor, the relation of one organ to another,
and of the child to the mother, instruct her in the
general principles of hygiene and the special duties
of the lying-in chamber, and the physician will have
an assistant that will be of inestimable value. It is
the aim of the Board of Managers of this institution
to supply the want, and they ask the public to assist
them in the task that they have voluntarily under-
taken.
In 1 86 1 a number of charitable ladies erected a
monument that will for ever tell the story of their
devotion to the poor women and children of this
) city. , Under the name of the " Brooklyn Homoeo-
pathic Lying-in Asylum," they located a home at
the corner of Lawrence and Willoughby streets.
For a long time they attended only to the immedi-
ate wants of their patients, but as mother after
mother left the institution with her little one, not
knowing where she should lay her head, it became
evident that a permanent home for the children
should be provided, in order that the mother might
be left free to take care of herself. This step seemed
to them of more importance, on account of the
knowledge obtained of the manner in which babies
were disposed of. It was impossible for the mother
who left the institution to take proper care of the
children, and so the babies were sent to the Com-
missioners of Charity, and by them transferred to
the city home, or given away to any one that would
take them. How could the mother do anything
else ? She was poor, friendless, weak from her con-
finement, without money or employment, and with-
out a home. How could she care for her child ?
A great deal is said in our daily papers about
baby farming, and the demand is repeatedly
made for its punishment with promptness and
severity. The charge of " wholesale infanticide"
was made a short time ago at the Yorkville
Police Court, against Ellen Roberts, of East Thirty-
eighth street, New York; one of the witnesses
swearing that from January to July thirty babies
passed through this woman's hands and out of ex-
istence. It is also charged that many of these
babies are entrusted to her care by the Commis-
sioners of Charity. Other witnesses swore that the
babies were cruelly exposed to the weather, and
were improperly nourished. Mrs. Roberts denies
the charges, and claims to have taken as good care
of the children as her means would allow. I deny
that the fault is always with the mother, and I also
deny that baby farming, as it is called, is always a
crime. The poor woman who leaves the child to be
cared for has little money to pay, and consequently
the one in whose charge the child is placed is un-
able to give the proper food and attention. The
mother's heart is as warm under faded calico as un-
der the richest silk, and poverty never makes the
parting between the mother and her first-born easy.
God sheds his love on all, both rich and poor, and
that love is reflected from the mother to her child.
The fact of the matter is that the State should take
hold of this matter at once, and provide proper in-
stitutions and proper guardians for its young. The
mother gives her child to the State. In this great
country we need every life, and can ill afford to
throw any away. Our immense tracts of unim-
proved land, our undeveloped mines, our extensive
manufacturing interests, and more than all, our en-
tire political system, demand that our native-born
should be tenderly cared for, and the institutions
that have for their object the receiving of these
little ones should be sustained. Statesmen have
totally ignored this subject, and to-day our country
is suffering from their neglect. Statistics show that
one-half our children die before having reached the
fifth year, and of those that live, a large proportion
have the seed of disease in their system produced
by disobedience of hygienic laws. From this class
we derive the most of our candidates for our hospi-
tals, poorhouses, and prisons, and in place of a vig-
orous, energetic, hard-working race, we have sim-
ply paupers that tax the country for their support.
The Board of Physicians of this institution, after ma-
ture consideration, decided to lay this matter before
the Board of Lady Managers, and they saw at once
that the institution was doing only a part of its
work. And so a nurse committee was appointed,
and they immediately entered upon the work as-
250
The Medical Union.
signed them. In a very short time a dozen cradles,
beautifully equipped, were provided, and they were
no sooner provided, than a dozen of little babies
were found to occupy them. The institution has
cared for 154 babies up to the present time, and the
statistics show that out of that number we have lost
but nine by death. That many have been adopted
into comfortable homes, and that the others are at
present with us in the institution, or else have been
returned to the mother whenever her circumstances
enabled her to take care of the babe. The success
of this department led to the establishment of a
child's hospital, and then the call was, of course, for
proper nurses to attend not only the sick children,
but the mothers of the children. This gave the
ladies an opportunity of establishing a school for
training nurses, and so our responsibilities were in-
creased four-fold, and our name was changed to
" The Maternity." I have devoted some time to
the history of this institution in order to show the
steps leading up to the establishment of the school.
Without the other departments, it would be impos-
sible to give the nurses that clinical instruction that
is of so much importance as to be, in fact, the life
of the school. In this country I believe there are
but two institutions of the kind for the education of
nurses, and they differ very materially from ours.
In Europe the schools are to be found in every large
city, but the Glasgow Maternity is the one that
seems to us the most successful, and we have decided
to follow out its course with but few modifications. It
embraces a lying-in asylum and a school for nurses.
It is managed by a board of laymen and physicians,
and is entirely self-supporting. All patients are
charged a small sum for their board, except they be
in actual labor at the time of admission, and are only
allowed to remain nine days after confinement, ex-
cept in cases of complication. In the school for
nurses it is necessary that the applicant have a
good reputation, and be more than ordinarily intel-
ligent. If accepted, she pays twenty-five dollars,
and is assigned to a room called " Nursery," which
is simply a large room for the nurses to sleep
in. She is there assigned a patient, and is to
attend her while the patient and her offspring
are in the house. The resident physician is
selected from the graduating class of the Uni-
versity college, and holds his position only three
months, but is never called upon except to attend
cases of complicated labor, and if the case is beyond
him he calls upon the consulting board. Twice a
week the nurses attend lectures, and they, are con-
stantly attending cases.
After having served-three months and individually
confining patients, they are given a certificate. The
lectures are almost all upon complicated labor, and
are attended by the students as well as nurses. The
students from the University are allowed to go
through the wards with the professor on Saturdays.
In order to stimulate the nurses to increased exer-
tion in their studies a list is kept at the Maternity,
and those whose duties are best performed are the
first to be recommended for positions in institutions
or for private nursing.
So popular has this institution become that the
management have sometimes to reduce the time of
attendance to six weeks in order to accommodate all
of the applicants. The amount of good accom-
plished by a school of this kind is incalculable.
Year after year a number of nurses are graduated
who have had advantages that cannot be obtained
elsewhere, and a higher grade of nurse is the result.
If this school is a success, and there is no reason to
doubt it, our graduates will be sought for in the
charitable institutions of the country, and will there
have an opportunity of imparting the knowledge
gained here to others, and so the good seed will be
widespread. This is an age of advanced civilization,
and the profession owe it to themselves to see that
this important department keeps pace with the
spirit of the age. Thousands of lives are thrown
away each year by careless or incompetent nursing,
and physicians frequently find their best efforts para-
lyzed by the inefficiency of the nurse. The friends
of the patient may be ever so devoted to him, and
anxious to do every thing that lay in their power,
but they cannot hope to obtain that skill in hand-
ling the sick that is the result of months and even
years of experience.
Our first class will play a very important part in
the establishment of this school. Much will be ex-
pected of its members — much more, alas ! than
should be expected of them from the short time of
service here ; but if they do their duty to themselves,
they will lay so good a foundation here that success
is sure to await them. There will be many hard-
ships, but the pleasure derived by seeing their pa-
tients convalesce will more than compensate them
for the care bestowed. I know of no position in life
where it is possible to attract strangers so warmly to
one as in the sick-room, and the faithful nurse will
never want a friend. We council you to be patient,
ever watchful and kind; be vigilant, wakeful and
gentle. Study to anticipate your patient's wants,
and do not be discouraged if you meet complaints
instead of praises. Remember that cleanliness is next
to godliness, do not forget the importance to the
sick of absolute rest of body and mind ; remember
that the physician's instructions are to be followed
under all circumstances, and do not make invidious
comparisons between members of the profession.
Be honest and upright in all of your dealings with
the sick, and remember always the golden rule,
" Do unto others as you would be done by." You
will have many opportunities of doing good by
your own example, and by assisting others to keep
up their courage in the hour of need. You will
also learn how much of good is developed in what
is called fashionable society when trials come that
call for your aid. The world is not half as bad as
many think, and the physicians and nurses see much
more that is good than the reverse.
One word of caution and I have finished. The
relations existing between the family and the nurses
are often so intimate that sacred secrets will be
placed in your keeping, and you must guard them
well. Many a family has been broken up by the
failure on the part of the nurse to keep her own
counsel. Let this lesson be remembered by each
one, that you may never regret the confidence re-
posed in you by your patient. If this one lesson is
fully impressed upon your mind, the first lecture of
the course will prove one of the most important.
Nurses, I assure you, on the part of the lady man-
agers, that you shall be kindly received and well {
cared for. I assure you, on the part of the Board
of Physicians, that no effort shall be wanting to as-
sist you in gaining the education that you desire,
and we shall expect from you application, perse-
verance, industry, and a determination to overcome
The Medical Union.
251
all obstacles that may lie in your path. With this
' frank statement of what we propose and expect, I
have the honor of announcing the New York State
School for Training Nurses as formally opened.
Brooklyn, New York.
Corresponbence*
State Homoeopathic Asylum for Insane.
Middletown, N. Y., Nov. 20th, 1873.
Friend Guernsey, — I feel mean every time I
think of you and of the Union, to whose columns I
want to be a contributor ; which I am prevented
from being by the many cares devolving upon me
here. I lead a busy life, indeed ; scarcely in any
sense a professional one, except in that I am pre-
paring an arena for future professional labors and
observations, which may reasonably be expected to
redound to the credit of homoeopathy. A day's
work with me, now, is a most curious melange of
the duties pertaining to the farmer, sanitarian,
landscape gardener, accountant, etc., etc. — dealing
with laborers, advising with architect and builders,
keeping the run of pay-rolls; obtaining estimates
and specifications for gas supply, steam-boilers and
fixtures, kitchen and bakery apparatus, pipe sub-
ways, drainage and grading; answering corres-
pondence and receiving visitors ; conferring with
trustees, and acting as secretary for committees,
etc., etc. You can imagine it to be " lively scratch-
ing" altogether.
We are crowding and pushing to get our main,
or administrative building, finished, so as to allow of
its occupancy by the latter part of December. It
will afford room for all purposes of administration
and for 65 to 70 patients ; and we have already,
since July 1st, received applications for full a third
of this number. As we cannot very conveniently
accommodate both sexes in this building, we shall
probably receive only women into it ; accommodat-
ing male patients in the new building, which is now
being rapidly built.
This new building — Pavilion No. 1, as we desig-
nate it, for convenience — is to be devoted entirely
to patients. It is 204 feet in length, and 3 stories
in height above the basement, with a wing on the
southerly end, seventy feet deep, and on the north-
erly end a wing one hundred feet deep, and is to
be built of brick and half timbered work, so con-
structed as to give it the appearance of three dis-
tinct villas, slightly connected by balconies and
glass-covered galleries, thus avoiding the prison-
like style generally followed in similar institutions.
Externally, I think, this pavilion, when finished
will be considered as even more attractive than the
main building, beautiful as that is. Charming,
however, as its exterior is to the eye, the interior
arrangement is still more graceful and home-like —
indeed, the home-like has been, and will be, a sine
qua non in the planning of all the buildings of this
Asylum. As each floor is the duplicate of the
others, a brief description of one will suffice. En-
j tering at the southerly wing, we find it appropriated
to a reception room for patients ; a patients' parlor
and ample dining-room; clothes-room, stairway,
etc. Passing thence into the centre of the build-
ing, we enter into a fine corridor no feet long and
1 2 wide, on either side of which are patients' rooms,
each 10^ by 14 feet wide, and an associate ward
20 by 2\Vz feet in size. The usual monotonous
outline of such a hall is in this case broken by a
charming octagonal room, or alcove, at each end of
the corridor, and a pleasant bay-window room in
its front, in the centre. Everything is bright, cheer-
ful and airy. Emerging from this corridor into the
further or northerly wing, we find ourselves in a
transverse or intersecting corridor 85 feet long and
10 feet wide, on one side of which are six rooms,
9 by 12, and a dining-room 13 by 15 feet, with but-
ler's pantry, etc. On the other side are bath-rooms,
water-closets and attendants' rooms. This wing
will be exclusively devoted to excited patients, and
is separated by double doors, thick walls, etc. ; ex-
cluding noise from annoying the patients in the
other portions of the building. At this end of the
building is a fire-proof stairway, from basement to
third story, situated conveniently for the passage of
patients from one part of the house to another, and
for escape in case of fire.
As in the main building, the closest attention has
been paid to securing proper ventilation, sufficient
light and warmth, etc., etc. The same energetic
builders, Messrs. Lyons, Fellows & Bunn, of New
York city, who have put up our main building,
have obtained the contract for this, and have dis-
played remarkable diligence and skill in its con-
struction. Its walls are already ready to receive
the second tier of floor-beams. It is built of brick,
with Ohio stone stone-dressings, in much the same
general style as the other building, though so
varied in some of the minor details as to make it
not " as like as two peas " to that. We esteem our-
selves as indeed fortunate, in having the services of
so tasteful an architect as Mr. Carl Pfeiffer, who
combines thorough architectural culture with an ear-
nest desire to secure the benefits of sanitary science.
Our future pavilion-buildings (three in number)
will probably be, in internal arrangement, and to
some extent externally, similar to Number One.
Our boiler-house, a neat brick building of y^ by
34 feet, with slate roof, is nearly ready for reception
of the boilers and engine. It is located 376 feet in
the rear of the administrative building, and in the
same locality will be located our gashouse, etc.
In the improvement and ornamentation of our
land (250 acres) we have not, as yet, made much
progress, for we have had need of all of our appro-
priation for purposes of construction. A good
beginning has, however, been made by the laying
down of a carefully arranged system of drain pipes,
by which the slopes of the ground along the front
of the buildings are drained ; and by the construc-
tion of a solid bed for the main road of approach
to the administrative building.
Although a State institution, there are several
things (necessities for such an institution) which we
must wait for for many years to come, unless pri-
vate munificence steps in to our aid. There are
many ways in which wealthy homceopathists might
testify their appreciation of the blessings of the
Hahnemanian faith, by aiding us to complete our
equipment, and fill out the full measure of our use-
fulness to the unfortunates in our charge. At the
same time, such gifts would form a most lasting
memorial of their kindness. We need pictures for
our walls — musical instruments for our patients'
parlors — flower-stands, baskets, and delightful nick-
nackeries for our patients' halls and sitting-rooms
252
The Medical Union,
— we need games, puzzles, etc., for our amusement
rooms — books and papers for patients' use — statu-
ary, vases, etc., for our grounds (ought we not to
have a life-size statue of the immortal Samuel him-
self, on a high pedestal in the midst of the noble circle-
drive before our main building — seen from every
part of the drive and the grounds?) — we need a
building, accessible to all the pavilions, in which can
be located our chapel, our bowling-alley, gymnasium,
museum, etc. All these wants (and you may think
them too numerous) are necessities in our work of
curing the mind diseased — they are part of our
working apparatus. If we wait for the State to build
them, or give them, we shall wait for many, many
years, — since the State has many children and
many demands upon its time. And how can our
private citizens — who acknowledge their frequent
personal indebtedness to homoeopathy — better tes-
tify of the faith that is within them, or better erect
for themselves a lasting and useful memorial, than
by aiding this asylum to step forward, at once, into
the front rank of such institutions ? For this is the
first and only existing State institution in the world,
as far as I know, which flies the flag of homoeopa-
thy, and we want it to be a glorious success !
I believe there are hundreds of men, and women
too, in this and other States, whose hearts have
been brought into sympathy (by actual experience)
with the subjectof the care and cure of the insane, and
who (could they be informed about us) would do what-
ever was in their power to make this new Homoeo-
pathic Asylum for the Insane, a bright, cheerful,
attractive (and as far as possible a happy) home for
these unfortunates.
But, my dear doctor, my hobby has ran away
with me. For your sake, oh ! patient man, I curb
him. Vale I H. R, Stiles.
Curing Leprosy. — The Madras surgeon in med-
ical charge of the penal settlement at Port Blair,
believes he has made an important discovery in cur-
ing leprosy. The oil of the gurgan balsam, or wood
oil, has long been used all over India, by the natives,
for skin diseases and sores, with good effect. It is
said its curative action in leprosy is marvelous, the
disease rapidly yielding to its action.
Chloroform Intoxication. — The introduction
of a piece of ice in the rectum is said to be one of
the most active agents in bringing a patient back to
life when under the influence of chloroform. As
the ice melts in the bowels the patient is seen to
draw a long breath, which precedes natural respira-
tion and the re-establishment of the cardiac
functions.
The Inventor of Anaesthesia. — An English
writer, speaking of the recent discussion upon anaes-
thetics in this city, gives what he considers the
real facts of the case, as follows :
" Discoverer of anaesthetic properties of nitrous
oxide, Sir Humphrey Davey, 1 798 ; discovery of
anaesthetic properties of ether vapor, Farraday, 18 18;
and of chloroform, Waldie, of Liverpool, in 1847.
First employer of nitrous oxide, Dr. Horace Wells,
1844; establisher of nitrous oxide, Dr. Evans; first
employer and establisher of ether vapor, Dr. Mor-
ton, 1846; first employer and establisher of chloro-
form, Sir J. Y< Simpson, 1847. .
Diabetes Cured by Lactic Acid. — In the No
vember number of the Homceopathic Journal of Ma '
teria Medica, Dr. Ritchen gives two very interesting
cures of Diabetes, by lactic acid. In both cases the
urine was loaded with sugar; but in a very short time
the specific gravity was reduced from 10.37 to a natu-
ral standard and healthy urine. The treatment was,
two tea-spoons of lactic acid in a tumbler of water,
to be drank during the day, and the same quantity
repeated each succeeding day, until convalescence
was established.
The diet was of beef, mutton, eggs, and water with
just sufficient brandy or whiskey to modify the taste.
The treatment lasted not quite four weeks.
The doctor very pertinently enquires, " Would a
dilution of the acid produce the same effects ? " and
suggests that some of our high-dilution friends pub-
lish the results of actual trials.
Local Employment of Chlorate of Pot-
ash in Cancerous Sores. — In the Berl. Klin.
Wochenschrift, No. 6, 1873, Dr. Burrow, of Konigs-
berg, advocates the local employment of Chlorate
of Potash in the treatment of cancerous sores. His
proceeding consists in sprinkling the sore with
Chlorate of Potash in powder or crystals, and cover-
ing the whole with a wet compress. As the crys-
tals of Chlorate of Potash exert a more powerful
action than the powder, and excite greater pain,
Dr. Burrow uses the powder first, and replaces it by
the crystals when sensibility has been abated. One
of the cases was a cancerous sore of the left arm,
which healed completely after eight weeks' treat-
ment. Three other cases were cancerous sores of
the breast; one was lost sight of, the other two
are under treatment and healing well. The fifth
case recorded was connected with a cancer which
originated in the periosteum of the upper jaw and
left cheek bone, and this became ulcerated; in this
case healing was complete in three months.
Oleate of Mercury in Ringworm.— Dr. Cane
speaks very highly of this remedy, in the cure of a
trouble which is sometimes very obstinate. He
sums up the advantages under the following heads :
1. It is a certain remedy, if carefully applied.
2. It produces no staining or injury of the skin,
and is painless in its application.
Dilation of the Cervix Uteri in Dysmenor-
rhea.—Dr. Ellinger, of Stuttgart, employs in
rapid dilatation a sort of modified polypus forceps,
which are introduced into the narrowest cervix. In
case any part of the canal offers any resistance to
the progress of the instrument, by separating the
arms of the instrument for a few moments the stric-
ture above is forced to yield ; so that in this way a
cervix which presents great difficulties to the intro-
duction of the sounds, allows the dilatorium to pass
with facility. The pain is said to be not greater
than the introduction of Simpson's sound. He
recommends extemporized dilatation : 1. In stricture
of cervical canal. 2. Stenosis due to flexion. 3.
Metrorrhagia in a flabby, swollen uterus, but without a
new growths. 4. Retained catarrhal secretions. 5. *
For exploration of uterine cavity. 6. Replacement
of a flexed uterus. 7. Sterility. Dr. Ellinger
thinks, where dilation is justifiable at all, the rapid
dilation is vastly superior to any other form.
The Medical Union,
253
The Medical Union
A MONTHLY JOURNAL
Of Medicine, Surgery, and the Collateral Sciences.
Editors :
EGBERT GUERNSEY, M.D. CHARLES E. BLUMENTHAL, M.D.LL.D.
JOHN C. MINOR, M.D. ALBERT E. SUMNER, M.D.
H. M. PAINE, M.D.
Published on the First of each Month, by
C. T. HURLBURT, 898 Broadway, New York.
NEW YORK, NOVEMBER, 1873.
"A regular medical education furnishes the only presumptive
evidence of professional abilities and acquirements, and ought to be
the only acknowledged right of an individual to the exercise and
honors of his Profession." Code of Medical Ethics, Amer. Med.
Ass., Art. iv, Sec. i.
The publisher of The Medical Union, de-
sirous of commencing the new year with a greatly
increased subscription list, offers to all new subscrib-
ers for 1874, the November and December num-
bers of the present year. If those who approve the
course of the journal will endeavor to extend its
circulation among their professional brethren, they
will enable the editors to increase its attractions,
and render it still more worthy their support.
THE FUTURE.
In January, 1873, we commenced the publication
of The Medical Union, believing, if conducted
according to the plan we proposed, it would form a
reliable medium for the interchange of thought,
and occupy a useful position in the field of medical
journalism. Having positive opinions of our own
upon most of the leading medical questions of the
day, and fully realizing the fallibility of human
judgment, we were quite willing to give a fair and
respectful hearing to all who could present some-
thing of real practical value, though their theoreti-
cal opinions might differ from our own. While
the law of similia, the corner-stone of the homoeo-
pathic school, has no firmer believers or consist-
ent advocates, though perhaps many more able
than ourselves, we still believe that this law does
not, include the whole of medical science, or that
the pages of a medical journal, claiming to be
scientific, striving to be fully up with the advanc-
ing spirit of the age, and the ever broadening and
deepening current of scientific investigation, should
be solely confined to mere symptomatology. In the
early history of our school, the frequent discussion
of its peculiar principles was more necessary
than at present. Now, the battle has been fought,
and homoeopathy no longer stands before the world
as a doubtful experiment, but as an assured scien-
tific success. If our school is to continue a success
and still further change the current of medical
thought, and achieve even grander triumphs in the
future than in the past, it can only be by fully com-
prehending the spirit of progress which exists in
every part of the medical world, remembering that
science, with its swift and firm footsteps, has crushed
out many old abuses and crude ideas, and is daily
demonstrating new facts, and opening the paths to
grander truths. Standing as we do, far in advance
of every other school in therapeutics, we must not
forget that this is only a portion of the great whole,
and if we would maintain the position before the world
of scientific and successful physicians, it can only be
done by being fully alive to the vast advances
which are every year being made in those various
departments of knowledge so closely connected
with medicine; a correct understanding of which
so materially aids the physician in the intelligent
application of therapeutics, and in the prevention of
disease. The Medical Union will, as heretofore,
maintain a broad and liberal position, and while it
gives the place to the law of similia, which it
merits as the corner-stone of a correct therapeutics,
it will gladly welcome to its pages the practical
teaching of honest, earnest workers in the great
field of scientific investigations in the various de-
partments of medical science.
The past of The Medical Union foreshadows its
future ; with constantly increasing facilities, and an
enlarged clientage, we hope to make it still more
worthy the confidence and support of the profession.
Those who look upon a medical journal only as a
record of isolated cases, showing the almost mirac-
ulous effect of this or that potency, and an array of
wonderful symptoms worked from wonderful drugs,
will not be likely to find The Medical Union
a journal to their taste. To the great body of
physicians who look upon their profession as ever
on the advance, and who wish to see in their jour-
nal a picture of medical progress, a full and fair
discussion of great principles and a gathering
together of important facts, which will enrich and
enlarge the domains of therapeutics, and increase
their sphere of usefulness, we believe The Medical
Union will be an ever welcome and instructive
visitor.
To those of the profession who approve of the
course of the Union, we appeal, to increase its
sphere of usefulness, by sending us the fruit of their
own investigations, the record of cures performed.
254
The Medical Union.
and those instructive facts which every physician
in active practice accumulates. In this way we
shall be able to spread before our readers a
monthly feast, in which every one will find some-
thing to enjoy.
THE INSANE ASYLUM.
The suggestion made by Dr. Stiles, in his letter
on another page, that the friends of the State Insane
Asylum can materially add to the comfort of the
rooms and the pleasure of the inmates, by donating
pictures and the works of art to place in the wards,
and about the building ; also, games and books for
the amusement and instruction of the patients, is
worthy of their careful consideration and prompt ac-
tion. This is the only institution of the kind in
the world which flies the homoeopathic flag, and
here homoeopathy is to a certain extent on trial.
We cannot expect the State to furnish what might
be considered luxuries; and yet, by making the
rooms more beautiful, the atmosphere of home
could be brought within the walls, and the dreari-
ness of confinement softened. There are hosts of
ladies whose ample purses and exquisite tastes
have made their own rooms beautiful with works of
art, and whose libraries are stored with the choicest
gems of literature, who, perhaps, in looking over
their treasures could find some book, or picture,
or some game which they could spare, to make
bright the home of those in whom the light of
reason is clouded. If the physicians throughout
the county will take this letter of Dr. Stiles, and
read it to their wives and their lady friends, we are
confident there will be no lack of donations ; that
books will pour in to fill the shelves of the library,
and pictures to make bright and beautiful the walls
of the rooms. The publisher of The Medical
Union will gladly take charge of any donations, or
they can be transmitted directly to Dr. Stiles,
Middletown, New York. There is another sugges-
tion of the Superintendent which strikes us as ex-
ceedingly timely, and which more strictiy comes
within the province of- the physicians. It is the erec-
tion on the beautiful drive, which sweeps round in
front of the buildings, a life-size statue oiHahneman,
worthy the subject and the place. This would be
every way appropriate, the institution being under
homoeopathic direction, and Hahneman as super-
intendent of an insane asylum, being one of the
first to inaugurate that new system of kindness and
humanity which holds out some chance of bringing
the patients back to reason and restoring them to
their homes. What more appropriate than a gift
like this from the physicians of the State ? The
editors of The Medical Union start the list with a
subscription of one hundred dollars. Who will follow ?
WHAT WILL THE WOMEN DO THEN? POOR
THINGS !
" The north wind doth blow,
And we shall have snow;
Then, what will the robins do then ? poor things !
They'll sit in the barn,
And keep themselves warm
By hiding their heads in their wings, poor things. "
LUCKY birds to have a barn to go to ! With this
suggestive text from Mother Goose, we approach
the question of woman's work. The winter before
us is likely to be a hard one for the poor, and an
anxious one in all classes of society. Following
rapidly after the financial panic, comes a wide-
spread stringency and embarrassment in business,
which results in throwing thousands of men and
women out of employment. Even those whose in-
come before the panic was sufficient for their sup-
port without manual labor, are now compelled, in
many instances, from the depreciation of invest-
ments, to seek for means of earning their daily
bread. Widows and daughters who have been able
to live comfortably on the income derived from
"safe investments," are now obliged to go out into
the world and undertake a bitter struggle. Ladies
and gently reared girls who have never known any
other duties or accomplishments than those which
are found in the home circle, now that the circle is
broken, are seeking employment outside. God
help them ! Let every man who has a wife,
daughter or sister dependent on him for present or
future care think seriously of this matter. If the
time ever comes when they are to be thrown on
their own resources for support — what can they
do?
Perhaps they are so accomplished as to be com-
petent as teachers. But the supply of teachers far
exceeds the demand, and to-day the city is crowded
with professional teachers trained to the occupation
by life-long study and experience; and yet without
employment. Whether they try for some position
as governess, or seek employment in sewing, or ad-
vertise for occupation as a housekeeper, in every
and all departments there is so much competition
— so few vacancies, and so many applicants,' that
the probabilities of success are all against them.
No wise father would ever think of bringing up a
son in such a way as to be completely unable to
earn his support. Would it not be equally wise
to train up the daughters to helpful knowledge and /
valuable employments ?
No wise parent would arm his son against future
contingencies, by teaching him only the duties of
a hod-carrier, when he could just as well give him
The Medical Union.
2SS
\ the opportunity of mastering a good trade, or enter-
ing a business or profession. Would it not, then,
be equally wise to give the daughter a chance of
more profitable employment than as a poor sewing-
girl, or an under-paid teacher ?
If men and women would look at this question of
woman's work, without being prejudiced by pre-
conceived notions, if they would only meet the
question intelligently, in its application to them-
selves and their families, they would be able to
remedy much that is wrong in principle and prac-
tice, and accomplish without difficulty what many
earnest friends of poor women have long been striv-
ing for.
A true reform is never accomplished by "agita-
tion." If it is founded on wise, just and moral
grounds, it will steadily make its may and gradually
overcome the strongest prejudice. Unfortunately,
for our wives and daughters, " the woman ques-
tion" has had among its "agitators" some who
have retarded and baffled the efforts of the truest
friends of women, by dragging the whole question
down into the mire of politics, and some who have
prejudiced and disgusted the public by the advo-
cacy of filthy and blasphemous doctrines.
With these people we have nothing to do, and
their opinions are of no interest to us. Separating,
then, the question from all such complications, and
seeking for the means of employment which shall
enable our wives and daughters to support them-
selves in case of need, we find ourselves in a very
narrow field. In the ordinary occupations of work-
ing women, in factories, in sewing, in teaching,
there is no chance for employment, because the
demand for places is greater than the supply. What
other occupations can be followed ? Nursing, tele-
graph-operating, and one or two trades, but in all
these the same difficulty exists.
If we would go to the root of the matter at once?
we should say that thorough qualification in any
business, trade or profession, will insure remunera-
tive employment under ordinary circumstances. It
is useless to attempt to force incompetent women
into positions where incompetence means loss of
money to the employer. But the question of in-
competence is a purely educational one. And there-
fore, we narrow the question down to a matter of
education. We should have schools of pharmacy,
in which women should be thoroughly qualified in
all that pertains to the apothecary's art, for this is
an occupation for which women are naturally better
qualified than men.
We should have women instructed as book-
keepers and accountants, so that in banks, insur-
ance offices, and in general business, they would
perform the same clerical duties which are now
undertaken by men. Is there anything unlady-
like in being accurate at figures, in keeping ac-
counts and in being well paid for good work?
In the ordinary trades, we can see no good reason
why women should not be good tailors, shoemakers,
cabinet-makers and upholsterers, and in general,
pursue all the occupations which do not require the
severest manual labor. To learn these trades, how-
ever, special schools should be opened under com-
petent instructors ; and when a trade is mastered by
the pupil, her qualification should be determined and
attested by an independent board of experts. In
the development of this plan lies the solution of the
question of woman's relation to commercial pur-
suits. She must be technically educated first, and
then her interests and those of her employers will
be identical.
Rut should we not encourage a higher education,
a broader field, than this ? How shall we regard the
entrance of woman to the medical profession ? For
us, the question is to be determined by the sole
test of competence. If a physician is highly edu-
cated, thoroughly qualified in all that pertains to
the profession, and full of that wise charity that is
begotten of true learning, we are not only willing,
but glad of such an acquisition to our ranks, no
matter what may be the race, sex, or color of the
new-comer. But let us be sure, that the medical
education of women is at least equal to that of men,
that they have every facility for instruction, and
that their competence is attested by an independent
board of examiners.
We look for better things in the future, and are
confident that these opinions are widely spread, and
will rapidly develop most practical results. The
time will come wheln it will be better to be a
woman than a robin. Poor thing !
ALLOPATHIC COURTESY.
The American Health Association has recently
been in session in this city. It claims to have been
organized for the purpose of discussing sanitary
measures, and urging forward sanitary reform; and
one would naturally suppose that all who are actively
engaged in solving the great question of public
health, would be welcome to its active deliberations.
A glance, however, at the names of the getters-up
of the concern, and the executive board, would soon
dispel any illusion he might have of common fair-
ness or gentlemanly courtesy in their official action,
where homoeopathy is concerned. It is a curious
fact that men claiming to be Christians and gentle-
men whenever the name of homoeopathy is men-
tioned become rabid, and forget every gentlemanly
instinct and every law of Christian courtesy. That
one word is the Ithurial touch which wakens into
life all the slumbering passions of their nature.
256
The Medical Union.
The officers of the association are Dr. Stephen
Smith, President, and Drs. Moreau Morris, J. J.
Woodward, S. O. Vanderpool, William Toner, A.
N. Bell and Edward Jarvis, Executive Committee.
The names of these gentlemen, all of whom have
long been feeding at the public crib, will prepare
the reader for what follows :
When the list of names for membership had
been read, Dr. C. C. Cox, President of the Board of
Health of Washington, D. C, inquired why the Ex-
ecutive Committee had* failed to recommend two
names which he had presented. He understood
that this body was one of sanitarians, not of doctors,
and that views on homoeopathy and allopathy were
not to admit or debar gentlemen from membership
who were interested in the question of public health,
and engaged in solving its problems.
The President said he thought the gentleman
was not in order. There was no question before the
house, and he could not permit the gentleman to
speak so of the Executive Committee, as it was im-
proper to call their action to order.
Dr. Cox, however, calmly continued his argument
amid considerable disorder. He said he had named
Dr. Bliss and Dr. Verdi, two members of the Board
of Health of Washington, appointed by the Presi-
dent of the United States, and this Executive Com-
mittee had rejected them because Dr. Verdi was a
homceopathist, and Dr. Bliss had been expelled from
a Medical Board for an alleged breach of etiquette.
He wanted to know why the Executive Committee
proposed to pass upon the qualifications of members
thus, when the constitution distinctly said that quali-
fications for membership consisted only in an inter-
est in the establishment of the best sanitary measures.
There were laymen in that body who were as deeply
interested in such measures as the doctors, and the
Executive Committee exceeded their powers when
they rejected men because of peculiar medical tenets,
or alleged lack of etiquette.
During the delivery of this speech, Dr. Wood-
ward and Dr. McClellan were each trying to say
something ; the body of the members were crying,
"Order, order," and the President was alternately
calling Cox by name and rapping on his table. The
gentleman from Washington would not be put down,
and cries of "Adjourn" had become almost clamor-
ous, when Dr. Moreau Morris, finding a hearing,
said: "Mr. President, the gentleman has insulted
this association, and I move his expulsion."
An instant revulsion took place, and nearly all
present cried, " No, no."
" I insist upon my motion," said Dr. Morris.
"I should be very loth to put it," said Dr. Smith,
with dignity. "The gentleman has offended against
the rule of the association, but not so seriously. "
" If I am to be expelled from this association for
asserting my rights, not only as a member, but as
an American citizen," said Dr. Cox, "I will with-
draw, and throw myself upon the press."
Dr. Smith refused to put the motion, and as the
ordinary business of the association proceeded, the
excitement abated, and the incident was soon for-
gotten.
Comment is unnecessary. It is also unnecessary
to say, what was apparent to all, that the papers
read by the medical gentlemen who are supposed
to run the concern were characterized by an amount
of verbiage and facts which have formed the gist of
sanitarian works for the last forty years, the gather-
ing together of which would do no credit even to a
sophomorian. Outside of the regular medical gentle*
men, some of the papers were of rare excellence, —
full of sound, practical information and useful sug-
gestions. If these could be collected together and
published, they would form a very valuable addition
to our works on sanitary science, and serve to stim-
ulate legislation in the right direction.
DR. BUTLER'S MEDICAL REGISTER AND
DIRECTORY OF THE UNITED STATES.
A work is now being published by Dr. S. W.
Butler, editor of the Medical and Surgical Reporter,
which purports to contain the names and addresses
in full of all regular and irregular practitioners in
this country. Great expense is being incurred and
great effort is being made to render the list com-
plete and reliable. For several years to come it
will be considered The Standard Register of the
medical practitioners residing in this country. It is
of the utmost importance, therefore, that homoeo-
pathic practitioners should immediately furnish Dr.
Butler the information he desires to obtain. He
has mailed to over fifty thousand practitioners in
this country a blank slip, for the purpose of obtain-
ing not only their addresses in full, but also informa-
tion concerning the status of medical men, which, if
furnished, is sufficiently comprehensive to form the
basis of a biographical sketch of no inconsiderable
proportion of each representation of our profession.
The emanation of this circular under the auspices
of the allopathic school may have induced many
who have received it to treat it with indifference ;
indeed, a somewhat extended correspondence con-
firms the conviction that very few homoeopathic
physicians have responded to Dr. Butler's urgent
appeals. As this Directory is designed to contain a
complete record of both allopathic and homoeopathic
physicians, it is exceedingly important that each one
of the latter should not fail to immediately furnish
full information concerning himself; also full statis-
tical data regarding every homoeopathic medical so-
ciety and institution in his locality. In order to fa.
cilitate the furnishing of the desired statistical infor-
mation by homceopathists residing in the State of
New York, the Medical Director of the Atlantic Mu-
tual Life Insurance Company has recently supplied
every homoeopathic physician in the State with two
copies of a blank nearly similar in form to the one (
issued by Dr. Butler. He has also, in a short circu-
lar-letter, called attention to this important subject,
and has urgently solicited the active co-operation of
the homoeopathic profession. All who may receive
The Medical Union.
25;
copies of the blanks are requested to fill them and
mail one to Dr. S. W. Butler, 115 South Seventh
Street, Philadelphia, Penn., and the other to the
office of the Insurance Company, in the City of Al-
bany. Dr. Butler's Directory is, at the present
time, in an advanced state of preparation; hence,
there should be no delay in furnishing him the in-
formation he so urgently solicits.
LEPROSY IN THE SANDWICH ISLANDS.
By Charles Nordhoff, Esq.
By a law of the Kingdom, it is made the duty of
the Minister of the Interior, and under him of the
Board of Health, to arrest every one suspected of
leprosy ; and if a medical examination shows that
he has the disease, to seclude the leper upon
Molokai. The disease, when it is beyond its very
earliest stage, is held to be incurable. He who is
sent to Molokai is therefore adjudged civilly dead.
His wife, upon application to the proper court, is
granted a decree of absolute divorce, and may
marry again ; his estate is administered upon as
though he were dead. He is incapable of suing or
being sued ; and his dealings with the world there-
after are through and with the Board of Health
alone. In order that no doubtful cases may be sent
to Molokai, there is a hospital at Kalihi, near Hono-
lulu, where the preliminary examinations are made,
and where Dr. Trousseau, the physician of the
Board of Health, retains people about whom he is
uncertain.
There are at this time 804 persons, lepers, in the
settlement, besides about 100 non-lepers, who pre-
fer to remain there at their ancient homes. Since
January, 1865, when the first leper was sent here,
1,180 have been received, of whom 758 were males
and 422 females. Of this number 373 have died,
namely, 246 males and 127 females. Forty-two
died between April 1 and Aug. 13 of the present
year. The proportion of women to men is smaller
than I thought ; there are about 50 leper children,
between the ages of six and thirteen. Lepers are
sterile, and no children have been born at the
asylum.
When a leper is sent to Molokai, the Govern-
ment provides him a house, and he receives, if an
adult, three pounds of paiai (unmixed poi) per day,
and three pounds of salt salmon, or five pounds of
fresh beef, per week. Beef is generally preferred.
They are allowed and encouraged to cultivate land,
and their products are bought by the Health Board ;
but the disease quickly attacks the feet and hands,
and disables the sufferers from labor. There are
two churches in the settlement, one Protestant, with
a native pastor, and one Catholic, with a white
priest, a young Frenchman, who has had the cour-
age to devote himself to his co-religionists. There
is a store, kept by the Board of Health, the articles
in which are sold for cost and expenses. The peo-
ple receive a good deal of money from their rela-
• tives at home, which they spend in this store. The
Government also supplies all the lepers with cloth-
ing. There is also a post-office, and the little
schooner which carried me back to Honolulu bore
over 200 letters, the weekly mail from the leper
settlement.
For the bad cases there is a hospital, an exten-
sive range of buildings, where 100 patients lay when
I visited it. These being helpless are attended by
other lepers, and receive extra rations of tea, sugar,
bread, rice, and other food. Almost every one
strong enough to ride has a horse ; for the Hawai-
ian cannot well live without horses. Some of the
people live on the shore and make salt, which you
see stored up in pandanus bags under the shelter of
lava bubbles. When I was there a number were
engaged in digging a ditch in which to lay an iron
pipe, intended to convey fresh water to the denser
part of the settlement.
„ Such is the life settlement on Molokai ; a precip-
itous cliff at its back 2,000 feet high ; the ocean,
looking here bluer and lovelier than ever I saw it
look before, on three sides of it ; the trade wind
blowing across the lava-covered plain ; eternal sun-
shine ; a mild air ; horses ; and the weekly excite-
ment of the arrival of the schooner from Honolulu
with letters. There is sufficient enjoyment for
those who can and like to work — and the Hawai-
ian is not an idle creature ; and altogether it is a
very contented and happy community. The Island-
er has strong feelings and affections, but they do
not last long, and the people here seemed to me to
have made themselves quietly at home. I saw very
few sad faces, and there were mirth, and laughter,
and ready service, and pleasant looks all around us,
as we rode or walked over the settlements.
And now, you will ask, what does a leper look
like ? Well, in the first place, he is not the leper
of the Scriptures ; nor is the disease at all like that
which is said to occur in China. Indeed, the poor
Chinese have been most unjustly accused of bring-
ing this disease to the islands. With the first ship-
load of Chinese brought to these islands came two
lepers "white as snow;" having, that is to say, a
disease very different from that which now is called
leprosy here. They were not allowed to land, but
were sent back in the ship which brought them out.
The Hawaiian leprosy, on the other hand, has been
known here for a quarter of a century, and men
died of it before the first Chinese were brought
hither. The name Mai-Pakeh was given it by an
accident ; a foreigner saying to a native that he
had a disease such as they had in China. There
are but six Chinese in the Molokai leper settlement,
and there are three white men there.
The leprosy of the islands is a disease of the
blood, and not a skin disease. It can be caught
only, I am assured, by contact of an abraded sur-
face with the matter of the leprous sore ; and doubt-
less the habit of the people, of many smoking the
same pipe, has done much to disseminate it. Its
first noticeable signs are a slight puffness under
the eyes, and a swelling of the lobes of the ears. To
the practiced eyes of Dr. Trousseau, these signs
were apparent where I could not perceive them un-
til he laid his finger on them. Next follow symp-
toms which vary greatly in different individuals ;
but a marked sign is the retraction of the fingers,
so that the hand comes to resemble a bird's claw.
In some cases the face swells in ridges, leaving deep
furrows between ; and these ridges are shiny and
without feeling, so that a pin may be stuck into one
without giving pain to the person. The features
are thus horribly deformed in some cases ; I saw two
or three young boys of 12 who looked like old men of
60. In some older men and women, the face was
258
The Medical Union.
at first sight revolting and baboon-like ; I say at
first sight, for on a second look the mild, sad eye
redeemed the distorted features ; it was as though
the man were looking out of a horrible mask. At a
later stage of the disease these rugous swellings
break open into festering sores ; the nose and even
the eyes are blotted out, and the body becomes
putrid.
In other cases the extremities are most severely
attacked. The fingers, after being drawn in like
claws, begin to fester. They do not seem to drop
off, but rather to be absorbed, the nails following
the stumps down ; and I actually saw finger-nails
on a hand that had no fingers. The nails were on
the knuckles; the fingers had all rotted away. The
same process of decay goes on with the toes ; in
some cases the whole foot had dropped away ; and
in many the hands and feet were healed over, the
fingers and toes having dropped off. But the heal-
ing of the sore is but temporary, the disease pres-
ently breaks out again. Emaciation does not seem
to follow. I saw very few wasted forms, and those
only in the hospitals, and among the worst cases.
There appears to be an astonishing tenacity of life,
and I was told they mostly choke to . death, or fall
into a fever caused by swallowing the poison of their
sores when these attack the nose and throat. Those
diseased give out soon a very sickening odor, and I
was much obliged to a thoughtful man in the settle-
ment, who commanded the lepers who had gathered
together to hear an address from the doctor, to form
to leeward of us. I expected to be sickened by the
hospitals ; but those are so well kept, and are so
easily ventilated by the help of the constantly
blowing trade wind, that the odor was scarcely per-
ceptible in them.
Che Jfte6ical Union Clinic.
Recently a lady of seventy-five years of age was
placed under my care for treatment. She had just
returned from Canada on a visit to her friends. I
saw her on the morning of her arrival in this city,
and noted the following points in her case : Numb-
ness of the hands and feet ; inability to walk ; tongue
slightly coated with a' brownish fur, and consti-
pated. Her appetite was fair, and did not com-
plain of any pain, but appeared to be more con-
cerned about the condition of her feet and hands ;
nor did she seem to be fatigued from her long and
rapid journey. In view of her trip to Canada, and
in consequence of a fall she received in trying to
walk, I gave her Arnica, which was continued for
twenty-four hours. I then gave her two or three
doses of Mercurius, which promptly relieved her
bowels. On the third day the tongue was coated
with a thick dirty, whitish fur; pulse ioo; restive,
with bad nights. Bryonia was prescribed. The
next day I found the pulse 114, the tongue dry,
parched, and glazed, the tips and edges red, the cen-
tral and posterior parts blackish, exacerbation of
the symptoms at night, with marked prostration.
I gave Rhus Tox. The next day she was more calm,
had a better night, with an improvement in her
symptoms, the tongue also less dry. The same
remedy continued. Under its action the patient
gradually improved, so that, in two weeks from the
time of the attack, the disease gave way to conval-
escence, and with it the disappearance of the^
numbness of the hands and feet and the return (f
of the proper use of the extremities. In the last
week of her sickness aching pains in the arms,
from the shoulders to the extremities of the fin-
gers, made their appearance, which caused much
suffering and disturbed her rest; they were not
constant; usually, they were even worse at
night or in the evening. Belladonna and Lachesis
did her some good. I must confess, however, I
was not as successful as I would have wished in giv-
ing her relief. As she left the city, for home, I
lost the opportunity of any further treatment of the
case, feeling confident of success if she could have
remained longer in my hands.
In every other respect she was well ; good appe-
tite, ability to walk, and sound sleep, unless dis-
turbed by a return of these pains. Upon examin-
ing the Materia Medica, it was more difficult than I
expected to find remedies corresponding with ach-
ing pains of the arms. — T. Houghton, M. D.
{Transactions of Societies.
THE CENTRAL PARK OBSERVATORY.
The Director of the New York Meteorological Ob-
servatory, Central Park, has issued his annual report
for 1872 to the Board of Commissioners of the De-
partment of Public Parks. After referring to the
operations of the pencil barometer, lately introduced
into the observatory, which records every change in
the temperature, and describing the construction of
the new metallic thermometer, which acts upon the
principle of the difference of expansion and contrac-
tion between brass and glass, the report goes on to
treat of the climatic change of the United States,
which has been lately attracting considerable attrac-
tion. A general impression prevailed that a great
change had taken place in the temperature of this
country within the last century.
With a view of sustaining the conclusions drawn
in the report for 1871, the Director states that the
investigation has been continued during the past
year, so as to bring the question to a complete con-
clusion. In the report of last year the temperature
was considered only in relation to the cold of the
Winter months, while an inquiry has been since
made into the changes in the Summer months of
June, July and August, with a similar result. Tables
are given showing the mean temperature of New
York, Philadelphia, Boston, Charleston and New
Haven, for these months, dating back as far as the
earliest records, and from the examination of these
records the general conclusion drawn is that there
has been no change in the temperature of the three
hot months of the year in any portion of the Atlantic
States. The highest mean monthly temperature
for New York was that recorded in July, 1825, when
the thermometer marked 8i°. The mean tempera-
ture for the three hot months in Boston is 2.66°
lower than that of New York, which is nearly therfj
same difference found for the cold months in last^
year's report.
Computing the rain-falls in successive periods of
ten years each, and comparing them together, it has
been found that there has been neither an increase
The Medical Union.
259
, nor a diminution in the quantity of rain. It has
1 also been ascertained that the average length of time
the Hudson had remained closed from 1817 to 1867
was about ninety-one days, taking the computation
from periods of ten years. Observations of this class
are pointed to in the report as being more reliable
than the records of the thermometer, and it is ob-
served that, in the case of certain European rivers,
their time of remaining closed, when considered for
long periods, does not vary more than a fraction of
a day.
In a lengthened report of the average temperature
of Hew Haven during the last forty-five years, it is
stated that only a difference of one-fifth of a degree
has been discovered between the mean temperature
for that period as compared with the records of
forty-one years previous ; and this is attributed to
the probable zero error in most of the thermometers
employed. The records of New Orleans, Cincinnati,
St. Paul, and other cities go to establish a like
stability of climate. The year 1836 is referred to as
an exception to the general uniformity. The mean
annual temperature of New York began to decline
in 1830, and continued so until 1832, when it re-
mained stationary for two years, and then fell again
during the two succeeding years, until it was found
to have fallen 7. 2°. It then commenced to rise,
returning in the same manner as it had fallen, until
it went up 5 . 8°. This remarkable variation extended
from Boston to New Orleans, along the Atlantic and
Gulf coasts, but did not occur in the interior of the
continent, as at Fort Snelling. This change of tem-
perature could be ascribed only to one or the other
of two causes, astronomical or terrestrial. If the
sun's light decline in brilliancy, there must be a de-
cline in the mean temperature, and vice versa. But,
if such were the case, the temperature would be
affected simultaneously at St. Petersburg and Fort
Snelling as clearly as in the Atlantic cities.
The Director then attributes this variation to in-
fluences of a local and temporary character, and pro-
ceeds to show the directions in which atmospheric
fluctuations cross the United States. In the Spring
of 1873, there were destroyed in Central Park alone,
nearly 8,000 deciduous and evergreen trees, and it
was estimated that in the country, from the Atlantic
to beyond the Mississippi, and from Virginia to Can-
ada, many millions were killed. It was recognized
that this great destruction was due to a sudden and
severe cold, which occurred about the middle of
March, when a strong and bitter wind set in from
the north-west, with sleet, while the thermometer
fell from 510 to 17.20. Charts are then laid down
illustrating the progress and direction of these
thermometrical and barometrical waves in crossing
the United States, and the influence exercised upon
the temperature of the regions over which they
pass, and the question is then put whether it is
possible, from the data thus obtained, to trace the
passage of American storms across the Atlantic
and predict the time of their arrival on the Euro-
pean coast.
With a view of answering this inquiry, the regis-
ters produced by the instruments at the New York
Observatory have been compared with those ob-
tained at Valentia and Falmouth, the distance under
consideration being about 3,100 miles. The result
has been to show that there are many atmospheric
waves which do cross the Atlantic, and that the
time of their passage may, within certain limits, be
predicted. If, in the case of an easterly wind which
is traveling about 200 miles in twenty-four hours,
the exact time be found by the lowest reading of the
barometer, and its speed be ascertained for twenty-
four hours before and twenty-four hours after that
time, the mean of these two numbers will give the
rate of the storm in twenty-four hours. If 4,200 be
divided by this last number the result will show the
number of days the storm will take to cross from
New York to Falmouth or Valentia. At present no
definite rule can be laid down to calculate the veloc-
ity of these storms ; but if the result of the next two
or three years' experience should lead to the con-
firmation of the foregoing theory, an invaluable
service would be rendered to home and foreign
commerce by indicating whether ship captains
about to leave port might be delayed by approach-
ing foul weather, whether they could get well out
to sea before its occurrence, and what would be its
duration. An instance may be taken from the
tables which will show the probable accuracy
of the rule given. On the 4th of October, 1869,
there occurred a low barometer at the New York
Observatory at 1 P. M. In twenty-four hours pre-
viously the wind had traveled 313 miles, and in
the twenty-four hours succeeding it made 286 miles.
The mean of these numbers will give 299 miles, by
which 4,200 being divided, the time of passage
across the Atlantic is found to be fourteen days,
and the date of its arrival at Falmouth the 18th of
October, which corresponds exactly with the actual
time of its arrival as recorded in the English
weather reports. From calculations made in eighty-
six atmospheric disturbances since 1869, expected to
cross the Atlantic, only three have failed.
From the tables appended to the report it appears
that the mean temperature for the year was 51.020,
the maximum being 95. 5 p at 3 P. M. on July 2, and
the minimum 3Q at 9.30 A. M. on March 5. The
total number of days on which rain fell during the
year was 105, amounting to upward of twenty-four
days' continuous rain-fall, and the depth of water
produced in inches was 42.49. Snow fell on twenty-
five days, equal to seven days of a continuous fall,
and the depth of the snow-fall was 40.37 inches.
The distance traveled by the wind during the year
was 65,132 miles, the prevailing wind being from
the west.
NEW YORK COUNTY HOMEOPATHIC MEDICAL
SOCIETY.
A monthly meeting of the New York County
Homoeopathic Medical Society was held on Wednes-
day evening, Nov. 12th, at the Ophthalmic Hospi-
tal. Dr. Allen was in the chair.
After the reading of. the minutes of the previous
meeting, the reports of the Bureau of the Diseases
of Women and Children were presented.
Dr. J. Robie Wood narrated some cases of sterile
ity. The first one had been married four years.
She gave as the most prominent and distressing
symptom, the sensation of great pain in the breasts
previous to her menstrual periods, whereon he pre-
scribed one dose of Calcarea Carb. 200. Within ten
months afterward she was delivered of a healthy
child. In another case of sterility, the Doctor found,
upon a digital examination, that the womb was an-
teflexed, and the os resting upon the vaginal wall in
such a manner that the entrance to it was obstructed.
260
The Medical Union.
He directed the woman to turn over upon her face
immediately after sexual congress. By this simple
treatment the desired object was attained, and with-
in one year afterward she became pregnant.
The Doctor also related a case of hydatids, which
were expelled shortly after the administration of Ly-
copodium.
Dr. Throop read a paper upon Uterine Surgery.
He took occasion to speak of the advantages of the
Sims speculum, and of the impetus that it has given
to the advancement of this branch of our art. He
deprecated the too extensive use of the knife, and
cited Dr. A. K. Gardner, as decrying the abuse of
operations, and advocating more conservative mea-
sures. It was his opinion that a very large class of
cases yielded more promptly under internal medica-
tion than the use of the knife. Electricity, he said,
was revealing itself as an agent of wonderful power
in the field of uterine therapeutics. The treatment
by passive movements was daily gathering trophies
in great numbers. Hygiene, also, was shown to be
of great advantage. The Doctor then spoke of the
great progress in uterine surgery in the old school,
and hoped it may become more widely a noble ally
in our worthy cause.
Dr. J. R. White reported the following case: A
lady, aged 32, of light hair and blue eyes, was de-
livered of a child. Ten months afterward she be-
came dropsical. Slight oedema of the eyelids was first
noticed, and general anasarca ensued within four
weeks. Her physicians had said that she had heart
disease, and were treating her accordingly. The
secretion of urine was almost entirely suspended,
her breathing became painfully oppressive, and the
patient grew continually worse. At last her friends
thought her dying, and I was called in. I found
her bidding adieu to her friends. The minister had
already been there, and the sacrament administered.
She was sitting, with her body bent forward, gasping
for breath, and had been unable to assume any
other position for four days. The urine was very
scanty, and for the few days previous, only a few
table-spoonfuls had been passed, and it was heavily
loaded with albumen. I put a half ounce of the
tincture of Apocynum Cannabinum in a half glass
of water, and gave two tea-spoonfuls hourly. After
the second dose its cathartic and diuretic action
was obtained, and several gallons of water were
passed off within the next twenty-four hours. The
patient began to improve immediately, and within a
few days was able to walk about. The Apocynum
was continued for some time, in alternation with
Helleborus Nig., and afterward followed by Arseni-
cum. The patient convalesced rapidly, and attained
a fair degree of health. I never could find any
traces of organic disease of the heart, and consid-
ered it Morbus Brightii. Two years afterward she
was again delivered of a child. Six months follow-
ing, general anasarca returned, and within four
months she died.
The Doctor contributed another case of anaesthe-
sia of the left leg, occurring after severe instrumental
labor, which was speedily relieved by Nux- Vomica.
He also spoke in this connection of the treatment of
pelvic peritonitis, and highly recommended as an ex-
ternal application, the following mixture : r>-. Tinct.
Aconit.-rad. ; Tinct. Belladonnas ; Chloroformi;
01. Oliv. ; ana. part, asqual. Misce. He applied it
upon cotton batting, and that should be covered
with oil silk.
The Doctor reported a case of ranula, whicn he i
had cured with Baptisia. He gave two drops of the '
third decimal, alternating every two hours, and
used the tincture as a wash. He had also derived
great benefit from this remedy in the treatment of
cancrum oris.
A discussion followed upon the cases which had
been reported, which was participated in very gen-
erally by the members present, after which the
meeting adjourned.
Reviews of Boohs,
A Manual of Midwifery, including the
Pathology of Pregnancy, and the Puer-
peral State. By Dr. Karl Schroeder,
Professor of 'Midwifery •, and Director of the Lying-
in Institution, in the University of Erlangen.
Translated into English from the third Gennan
edition. By Charles H. Carter, B.A., M. D.,
B. S., Lond. New York, D. Appleton & Co.
Perhaps for several years has the appearance of
a new medical book been more eagerly awaited,
than the translation of Schroeder's "Manual of
Midwifery," by the medical profession. Although
there were very many works upon this branch of
medicine, yet there was not one which contained
all the latest investigations and conclusions in the
physiology and pathology of midwifery, and as there
have been many new developments in these depart-
ments, which have been clearly demonstrated, a
work seemed needed which should embody them
together, with a practical treatise upon operative
midwifery. Those already before the profession
were all incomplete : they were either diffuse or
superficial, and blindly handed down many tradi-
tions which should be regarded as myths insepar-
able from the inaccuracies of an incomplete science
while in its elementary stages of development.
Cazeaux has been deservedly the favorite text-
book in this country, yet it devoted too much space
to speculations and theories, and did not point out
with sufficient distinctness those which are com-
monly accepted from the many insupportable ones
which are fast becoming obsolete. In some por-
tions of the book the subjects were obscurely
handled, and the chapters upon operative mid-
wifery did not fully embrace the views held by the
most advanced authorities.
Naegele has enjoyed even a more extensive repu-
tation as a text-book in Germany; yet it clung with
great tenacity to the traditions of the past, and did
not give sufficient prominence to the newer ideas
and later researches.
Schroeder strikes out boldly in a new path, and
has presented a book to the profession which omits
every thing that is not accepted, nor thought worthy
of consideration, by the latest investigators upon
this subject, and gives with conciseness the newest
and latest views upon every branch of his topic.
He writes tersely, boldly, and clearly, and handles g~
his subject with such mathematical exactness and \
simplicity as is fitting to a scientific subject. The
book shows evidences of careful study, and the
author to be a patient investigator, an extensive
reader, and a pains-taking and indefatigable worker.
The Medical Union.
261
The work has gained an extensive reputation in
Germany, having reached a third edition within
the short space of two years, and the translator is
so hopeful of its meeting a want in medical litera-
ture which has long been felt in this country, that
he deems no apology necessary in offering it to the
profession.
The author very properly omits the general anat-
omy of the pelvis, and speaks only of it with re-
gard to its function as the canal of parturition. It
has always seemed to us a great mistake with both
authors and lecturers, in trespassing upon the do-
mains of anatomy, and consuming much time and
space to the consideration of what properly belongs
to another department.
He opens the chapter upon the physiology of
pregnancy in so attractive a manner, that we can-
not forbear quoting it at some length. " Of the
thousands of ova which are found imbedded within
the Graafian follicles in the new-born female, com-
paratively few come to be expelled from the ovary.
As the opening of the tubular glands, from which
the Graafian follicles are developed by constriction
of a portion of the gland, are situated towards the
periphery of the ovary, the most developed follicles
of the new-born female will be found more towards
the centre, and this condition will remain the same
up to puberty. Not until the other organs of the
body have almost reached the highest degree of
maturity, does a new phase of development begin
in the organs of generation. This is seen in the
ovaries by the enlargement of the Graafian follicles.
According to Pfliiger, their slow, but continued
growth causes a constant irritation of the termina-
tions of the nerves which are imbedded in the rigid
stroma. This irritation, however, is so slight, that
it is not sufficient to set up immediately a reflex ac-
tion, but at periodic intervals the sum of those
irritations becomes so great that reflex action takes
place in the form of a considerable arterial congestion
of the genital organs. This suddenly increased afflux
of blood has a double effect. Not only is that Graafian
follicle, which is the farthest advanced in develop-
ment, ruptured by the increased intrafollicular pres-
sure, but from the vessels of the mucous membrane
also hemorrhage takes place upon the free surface of
the uterus. The escape of the ovum from the follicle,
and the menstrual hemorrhage, are both conse-
quences of one and the same cause, namely, of the
pressure which the growing follicle exerts upon the
terminations of the nerves contained in the ovarian
stroma. It is, therefore, this pressure which causes
the periodical reflex action in congestion of the
genital organs."
In speaking of the changes which take place in
the Graafian follicle, he contradicts the generally ac-
cepted opinion of the investment of the ovaries by
the peritoneum. According to Pfliiger, the surface
of the ovary is not covered by a perfect serous
membrane, but only by a single layer of epithelium.
Waldeyer and Kiister also positively state that the
peritoneum does not cover the ovaries, but that they
project free into the abdominal cavity through an
opening in the peritoneum, and are covered only by
the epithelium of a mucous membrane, the prolonga-
tion of which forms the epithelial lining of the tu-
bular glands of Pfliiger.
The passage of the ovum he thus graphically
describes : " The cilia of the Fallopian tubes vibrat-
ing in a direction towards the uterus, cause a con-
tinuous current in the fluid, which is always present
upon the peritoneum, in the neighborhood of the
abdominal opening of the Fallopian tubes. The cur-
rent is able to carry along with it very small sub-
stances, such as the ovum, and in this way the
ovum generally enters the v/ide abdominal opening
of the oviduct of its own side. The further advance
of the ovum in the external third of the oviduct,
is solely caused by the vibrations of the cilia, be-
cause the tube is here far too wide for the contrac-
tion of its muscular elements to act upon the small
ovum. But in the middle portion the oviduct be-
comes so narrow, that the contraction of the layers
of its circular fibres can grasp and push it for-
ward."
The development of the ovum and its mem-
branes is clearly described in a few pages, the au-
thor evidently thinking that an exhaustive treatise
of the subject should be more properly left to the
physiologist.
In the chapter on positions and presentations
the author reviews the opinions generally main-
tained at the present day, as to the cause of the
head presenting so disproportionately often, and
decides in favor of that suggested by Aristotle,
which tries to explain the position of the fcetus, by
means of the laws of gravity. He says that in very
numerous experiments made first by Duncan, and
then by Veit and Honing, in which a fcetus, re-
cently dead, was allowed to swim in a balloon filled
with salt water of a specific gravity, equal to that of
the fcetus, it was seen that the head lies lower than
the breast, and that the right shoulder looks down-
ward. As regards the fcetal attitudes and their
changes, according to this law in the erect position
the back of the fcetus must be directed forward and
to the left, and in the recumbent position back-
ward and to the right.
In treating of multiple pregnancy he gives a
clear exposition of the distribution of the mem-
branes, showing that the foetuses have the same
chorion if they are derived from the same ovum
and that those from different ova have always sep-
arate choria, although they may greatly atrophy
at the place of contact of the two ovas. The am-
nion, however, being formed neither from the
mother nor from the ovum, but from the embryo
itself, is only the prolongation of the abdominal
walls of the embryo, and must consequently be
multiple in several foetuses. The rare cases of
simple amnion may depend either upon laceration
and subsequent atrophy of the originally existing
septum, or the full development of the two mem-
branes may have been impeded by a close approx-
imation of both embryoes. " The placentae," he
says, "are originally always separate, since in all
those cases each embryo forms its own allantois,
which, independently of the other embryo, grows
toward any spot in the periphery of the ovum. In
different ova they may, but in a simple ovum
they always must be so close together, that they
more or less intimately coalesce."
The chapter on the diagnosis of pregnancy gives
the various signs very succinctly. He speaks of three
murmurs which may be present, during the lat-
ter half of the term, viz: The sound of the fcetal
heart, the so-called uterine souffle, or placental
bruit, and that originating in the umbilical cord.
He adopts Hecker's views as the most probable
that the latter arises in the umbilical region from a
262
The Medical Union.
flexure of the first piece of the cord at the umbilical
ring.
Labor is described under the appropriate title of
"The Physiology of Parturition," and the chapters
upon it reveal evidences of patient and untiring study
upon this intricate subject. Schroeder discards all
of the various theories rife excepting those which
rest upon anatomical and physiological facts, and
explains the phenomena of parturition upon that
basis alone. In speaking of the causes of the set-
ting in of labor, he says that "it has been conclusively
shown both by anatomical preparations and physio-
logical experiments, that the sympathetic is the
motor nerve of the uterus, and it is doubtful that
the sacral nerves have any influence in causing
uterine contraction, but they are more probably
inhibitory nerves.
' l The influence of the sympathetic in the expulsion
of the ovum is called forth by the irritation which
the ovum exerts upon the terminations of the nerves
on the inner surface of the uterus ; by reflex action
that irritation is transformed into motor activity.
"Only towards the end of the tenth month this
irritation begins to be exerted, because only then,
through fatty degeneration of the decidua, the
ovum becomes a foreign body in the uterus. The
fatty degeneration of the peripheral layers of the
ovum causes a separation between the ovum and
the uterus, which the resulting contractions com-
plete."
In the classifications of the positions and pres-
entations, he follows the simple order of the German
authorities. He divides the presentations into those
of the head, face, breech and footling, and agrees
with nearly all, that the transverse positions prop-
erly belong to the pathology of parturition, as they
are usually insuperable by the forces of nature.
The chapter on the diagnosis of the fcetal posi-
tions is one of great value to the American ac-
coucheurs, as containing a lucid exposition of the
manner of diagnosing by external manipulations.
It is practiced extensively in Germany for the pur-
pose of corroborating the diagnosis formed from an
internal examination, and is so dexterously per-
formed at Vienna that the position of the foetus
may be diagnosed with almost absolute certainty
by it alone. The method is considered so valuable
that it is always resorted to previous to making an
internal examination.
The mechanism of labor is described in a some-
what novel way to the English-speaking reader :
" The mechanism by which the uterus effects
the expulsion of the foetus is a double one :
" First, by the contraction of the unstriped muscu-
lar fibres, the contents of the uterus — viz., the ovum —
considered as a whole, are exposed to a uniform
pressure, which Schatz calls the 'internal uterine
pressure. '
" Now, since the muscles of the fundus are more
strongly developed than those of the lower portion
of the uterus, and since the internal os is devoid of
a muscular structure, the ovum is pressed against
that latter point, and consequently dilates it.
" Secondly, the uterus tends to assume a round
form by its contractions. This is obtained at the
expense of the longitudinal and the transverse
diameters, the antero-posterior being relatively very
small in the uncontracted condition. Then, the
uterus shortens from above downward and trans-
versely. Schatz calls that tendency of the uterus
to assume the round form, the ' form-restitution
power.'
"Whilst the internal uterine pressure uniformly
acts upon the contents of the ovum— viz. , the foetus
and the liquor amnii — the innate power in the uterus
to re-assume its previous form tends, by the short-
ening of the transverse diameter, to place longitu-
dinally what may perhaps have been situated very
obliquely, straightening at the same time the foetus,
which is strongly bent over its anterior surface;
and the breech also, which, by the shortening of the
transverse diameter, is forced more towards the
fundus, is subject to the same pressure, and this
acting through the vertebral column, pushes the
head into the pelvic inlet."
In considering breech presentations he advocates
the prompt and speedy delivery of the retained
head, unless that it is certain that labor will quickly
terminate spontaneously. The tendency in this
country is to wait too long for nature to act in this
condition, and nearly all of our teachers instruct not
to interfere until there are symptoms of immediate
danger to the child. As we cannot foresee the
moment when the first inspiratory movement may
take place, and the inspiration which then blocks
up the lungs with foreign bodies, and places the
life of the child in jeopardy, it has been our custom
to practice the rules which Schroeder gives here
upon the subject.
In the chapter on the use of chloroform in labor
he advocates its use in the strongest terms possible,
and considers it the duty of the physician to admin-
ister it whenever the pains are intense in character
or labor is difficult. He\ dismisses all the objections
to its use as not founded on facts, and shows by
accurate researches that labor is but very slightly
delayed, and hemorrhages are not more frequent
under its administration. For the same purpose
chloral is recommended; as also the internal and
subcutaneous use of morphia.
In considering the treatment of the insufficiency
of the expelling force he coincides with all the Ger-
man authorities in denouncing the use of ergot, ex-
cept in the after-birth period. Schatz has shown
by means of the tokodynamometer, that after the
use of ergot, the internal uterine pressure is con-
tinuously and greatly increased during the intervals,
and that the pains become more frequent, although,
less efficient.
" It is known," says Schroeder, "that it is just
this persistent contraction which brings the child
into danger, for during each contraction of the ute-
rus, as during a normal pain, the diffusion of
gases between the maternal and the fcetal blood is
not entirely stopped, but greatly limited, and in the
uniform contraction, such as is produced by ergot,
the diffusion of gases at the placental insertion
is impeded, and thus asphyxia is produced."
Although theory would seem to justify the rules
laid down so strictly as to its use, by the German
authorities, yet our own experience has shown it to
be a valuable and safe remedy in sluggishness of the
pains in multiparas, when not dependent upon ex-
haustion nor upon nervous excitement, and when the
os is fully dilated, and there are no malformations /
either in the child or in the pelvis and its cover- ™
ings.
Opium and chloral are highly recommended
especially when the feebleness of the pains is due to
great nervous excitement. He considers their ac-
The Medical Union.
263
tion due to the paralysis of the spinal sacral nerves,
which are supposed to be the inhibitory nerves of
the uterus.
The chapters on operative midwifery are tersely
written. A complete absence of illustrations in this
division is noticeable, and probably arises from the
fact, that the author considers oral instruction not
sufficient to teach this branch, but that practice
upon the dummy is requisite to become a dexterous
operator.
He reviews very carefully the different methods
of performing craniotomy, and decides in favor of the
English method. Although the removal of the
head is long and tedious with Barnes' craniotomy
forceps, yet as it may be performed without any
risk of injury to the mother, they have decided ad-
vantages over the cephalotribe. When the pelvis is
contracted, up to one inch, he advises the use of a
strong steel wire as recommended by Barnes.
Pelvic deformities are elaborately discussed, as
they are, generally, in the German text-books. In
considering eclampsia, he says but little definite is
yet known as to its etiology. He rejects the theo-
ries advanced by Frerichs and Halbertsmer, and
adopts Traube's and Rosenstein's as more plausi-
ble. According to the latter "the convulsions
depend not upon disease of the kidneys, but
upon two other conditions — a deficiency of al-
bumen in the blood and an increased pressure in
the arterial system, which, though commonly pro-
duced by disease of the kidneys, may under certain
circumstances arise independently of them. A
watery condition of the blood is peculiar to pregnant
women, and during the pains also, since the muscles
of the body are in a state of activity, the pres-
sure is increased in the arterial system." In the
treatment, although depletion seems to be indicat-
ed to relieve cerebral pressure, it does not produce a
lasting beneficial effect, as it increases the watery
condition of the blood and heightens the danger of
the disease. Experience decides greatly in favor of
the use of narcotics, that the activity of the volun-
tary muscles may be paralyzed, and thus the arte-
rial pressure diminished. Full narcosis should be
produced by chloroform, morphia, or chloral.
The author describes puerperal fever very elabor-
ately, and presents the most complete picture of
this terrible disease, in its various manifestations, that
we have ever seen.
He accepts the theory of its septic origin, and
defends it with great ability. The pathology is ex-
haustively treated in a most interesting manner, but
want of space forbids our alluding further to this
able article.
Schroeder's midwifery will not supplant text-
books now in use, as long as midwifery is taught as
at present in this country. The details of the
various steps of the operation are not dwelt upon
with sufficient minuteness, and the mechanism of
labor not so simply described as in many of the
older works. It is rather a work intended for ad-
vanced students and general practitioners, and to
whom it will be of incomparable value, as a manual
of midwifery.
that the demand for it is still so great as to call for
a second. It would be superfluous for us to write
an extended notice of a work which we presume
is in the hands of the leading practitioners of our
school, who have already subjected it to the test
of their own practical judgment. Without pretend-
ing to any great originality, the action of the various
drugs upon the different structures, and their char-
acteristic peculiarities are so admirably grouped,
and so clearly explained, as to render the work of
real practical use to the busy practitioner in his
daily work. It richly deserves a place in every
physician's library.
Scientific iBleanings.
Characteristic Materia Medica. By W. H.
Burt, M. D. New York, Boericke & Tafel.
We do not wonder, in looking over this little work,
that it has rapidly passed through its first edition, and
Transfusion in Cholera. — Dr. Hedder, of
Toronto, in the recent cholera epidemic, when the
patient was in collapse, and as it was deemed hope-
less, tried the effect of transfusion of milk warm
from the cow, with the most entire success. The
vomiting and purging ceased almost immediately,
the pulse became strong and the body warm.
Microscopical Appearances of Ovarian
Fluid. — Much has been said of late concerning the
microscopical appearances of the fluid of ovarian
tumors, and many of the late writers upon this sub-
ject claim the existence of a peculiar cell, which is
pathognomonic of this disease. Peaslee makes men-
tion of an " ovarian glomerulus, or gorged granule,"
as being "characteristic when met with;" and Atlee
describes the granular cell as pathognomonic of ova-
rian fluid.
T. Spencer Wells, in his recent work, " Diseases
of the Ovaries : their Diagnosis and Treatment,"
gives his views, as follows :
" There are endless differences in the contents of
ovarian cysts, and these differences seem to be in no
way dependent on the form of the cyst, or the ana-
tomical arrangement of their tissues. Even the many
strange epithelial developments are not accompanied
by any special kind of fluid."
The microscopical appearances are found to be
quite as varied as the ocular, and are said to consist
of, "Fatty granules" "Globular aggregations"
(granular cells of Atlee), "Large colorless colloid
globules" " Similar colloid globules, inclosing one
or several round granulated aggregations," and
those "which contain transparent flakes," "Flat
scales of horny crystals," " Cholesterine crystals"
and "Pigment."
Pure Water. — Water itself is a disinfectant;
and a large volume of water, when exposed to the
air, so rapidly "fines" itself by the oxidation of its
organic impurities that, when cooled and settled or
filtered, to remove its suspended ingredients, the
water of most of our streams is even more palatable
and wholesome than that taken from wells.
The Liberte, a Paris paper, informs the world
that the first operation of lithotomy took place on
the 14th of January, 1474, on the person of a
condemned criminal. The operation was success-
ful, and the man received a free pardon from Louis
XI, for having indirectly advanced the cause of
medical science.
264
The Medical Union.
Plants in Sleeping-Rooms. — Prof. Redzie, of
the Michigan Agricultural College, gathered and
analyzed specimens of air, taken from the college
greenhouse, where more than six thousand plants
were growing, to determine the amount of carbonic
acid. The room had been closed for more than
twelve hours, and yet he found the proportion of
carbonic acid was absolutely less than in the open
air without.
He remarks, if a room in which there are more
than six thousand plants, while containing more car-
bonic acid by night than by day, contains less than
any sleeping-room on this continent, we may safely
conclude that one or two dozen plants in a room will
not exhibit enough carbonic acid by night to injure
the sleepers.
Chronic Ulcers. — Nussbaum, of Munich, has
been very successful in healing chronic ulcers by an
ingenious plan of his own. He narcotizes the pa-
tient and makes a deep incision entirely around the
ulcer, and about one inch from the edge, checking
the sometimes copious hemorrhage by strips of lint
pressed into the wound. The next day the dress-
ings were removed and the whole covered with lint
kept wet with water, and the same dressing contin-
ued until the healing was well advanced. The last
step in the treatment consisted in applying straps
and bandages in the ordinary way. The rationale
of the method is simply that the incision severs
large numbers of dilated vessels that have furnished
the ulcer with nourishment. The only source of
supply left is the diminutive vessels which reach the
surface from beneath. The material supplied by
them is small in amount, and has time to undergo
change into formative cells and connective tissues
without being cast off at too early a stage by a new
layer of exudation pressing it from behind, for
whenever we have thick, creamy, and white or laud-
able pus, then we have new formations going on,
accompanied by the development of connective
tissues and the formation of young vessels as in
every healthy sore.
Burns. — Glycerite of Lime used in burns, is
said by De Brayne to soothe the pain, and to pre-
vent inflammation or diminish its intensity ; it is
prepared from recently slaked lime, one part ; gly-
cerine, fifty parts; chlorinated hydrochloric ether,
one part.
Abscess of the Liver Opening into the
Ascending Cava. — Dr. Leon Colin, Professor at
Val de Grace, records {D Union Medicate) a very
remarkable, if not unique, case of this observed by
him in his service at "Val de Grace. At the autopsy
it was found that an abscess of the liver had burst
into the ascending cava, and that there were second-
ary purulent collections in the pulmonary paren-
chyma. During life these purulent collections open-
ed into a bronchus, and the pus was expectorated,
which led to the error of supposing that the abscess
of the liver had penetrated through the diaphragm
into the bronchi.
Cancrum Oris Successfully Treated by a
Saturated Solution of Iodine. — Dr. J. S.
Miller reports {Kansas City Medical Journal, Aug.,
'73) three cases of cancrum oris successfully treated
by tonics, and the local application of a saturated
tincture of iodine, prepared by putting as much
iodine into the compound tincture as it would hold.
Isfews 3fem$*
Oxygen. — Pure dry oxygen does not cause the
oxydation of rusting of iron. Moist oxygen has
only a feeble action. Dry or moist carbonic acid
has no action, but oxygen containing traces of car-
bonic acid acts rapidly on iron, producing first a
protoxide, then a carbonate of the same oxide, and
lastly a mixture of protoxide and hydrated sesqui-
oxide.
Anecdote of the Late Dr. Nelaton.— The
Paris correspondent of a medical journal gives a
pleasant reminiscence of the celebrated Dr. Nelaton,
physician to the late Emperor, whose death was re-
cently announced by cable : "As I passed into the
hall I heard groans, evidently of a child in great
pain ; the door leading to the sick ward was ajar, and
I heard the voice of a man talking earnestly with a
little sufferer. There was something very affecting
in the imploring tones of the child's voice and the
tender and sympathizing replies of the physician,
and it seemed to me not wrong to witness unseen
through the crack of the half open door the scene
that was passing within. On a narrow pallet near
the window lay a fine boy, nine or ten years old, dy-
ing of cancer developing itself between the eyes
and behind the nose. It had not shown itself ex-
ternally, but had destroyed the sight, and was at-
tended by excruciating suffering. By his side sat a
stately white-haired man holding with one hand the
two of the little patient, while with the other he ca-
ressingly smoothed his hair. The child told the
story of his pain, i Ah, je souffre tant P ('Oh ! I suffer
so much'), to which the old man listened patiently,
promising to devise some relief. Then he rose to
leave, but first bent over the boy, and with tears
dropping from his eyes, kissed his forehead as loving-
ly as a mother. The white-haired man was the
world-renowned Nelaton."
Death from Swallowing an Artificial
Tooth with the Rubber Plate Attached. —
Dr. Charles E. Van Anden, of Auburn, N. Y., for
many years the physician of the Penitentiary Insane
Asylum, met with his death recently from a curious
accident. While sneezing, he drew into his throat
an artificial tooth with the rubber plate attached.
He attempted to draw out the tooth by means
of forceps, but failed. Dr. Briggs also failed in
every effort to remove it, and then forced it, as he
supposed, with an instrument into the stomach.
He died two days after the accident. On making a
post-mortem examination, the tooth and plate were
found about three inches below the larynx imbedded.
It had ulcerated through the aesaphagus and formed
an abscess, about the bifurcation of the Hronchial
tubes, which had penetrated into the lungs, pro-
ducing hemorrhage and consequent death.
Professor Huxley, the recently appointed Lord
Rector of the University of Aberdeen, proposes cer-
tain changes in the medical examinations. German
or French is to take the place of Greek, in the pre-
liminary examination, and the examinations in Nat-
ural History and Botany are to take place earlier in d
the course. ™
Erratum. — In the September number, in the
notice of the Harrisburg Hospital: for J. L.
McRechan, read J. L. McKeehan.
The Medical Union.
265
iDrigmal Articles.
MUSIC AS MEDICINE.
By A. K. Gardner, M. D.
" And it came to pass, when the evil spirit from God
was upon Saul, that David took an harp and played with
his hand. So Saul zvas refreshed and was well, and the
evil spirit departed from him.'''' — I Samuel, xvi., 23.
That fact, that music soothes the troubled soul,
is as old as Holy Writ, and I have quoted the above
passage to show that I do not pretend to give any
novel views, but if I can induce you to consider the
subject — if I can present to you any illustrative facts
— if, after having gone through from the " firstly to
the tenthly," safely passed the "finally" and the
" to conclude" — if I shall then arrive at an "appli-
cation," each for yourselves, the object I have in
view will be accomplished.
Music was once judged to be but an amusement,
as reading and writing were considered but luxuries,
or essential appendages to professional men. The
latter are now made compulsory in the diverse
monarchical governments of Prussia and the Sand-
wich Islands, where every one is compelled to read
and write ; and the former is taught in the public
schools of a large portion of this country.
But it is not with music as a luxury, a mere
pleasure, nor as an essential to education, ranking
with poetry as a refining, civilizing, elevating in-
fluence, which should, by permeating society, raise
man from grossness to aesthetic elevation ; it is not
to music in these relations, fruitful as the theme
might be found, that I desire to ask your attention,
but rather as an influence, potent with prophylactic
energy and curative capabilities — it is to music as a
medicine that I ask your ears.
The poet has, in well-known verse, said :
" Canst thou not minister to a mind diseased;
Pluck from the memory a rooted sorrow ;
Raze out the written troubles of the brain;
And, with some sweet, oblivious antidote,
Cleanse the stuffed bosom of that perilous stuff
Which weighs upon the heart ?"
And H. Kirke White wrote :
" 0 surely melody from heaven was sent,
To cheer the soul when tried with human strife;
To soothe the wayward heart by sorrow rent,
And soften down the rugged road of life."
In fact, music is a subject, and all a poet wishes is a
subject ; and, once seized upon, he will twitter away
forever ; but the condensation of so much empty
sound is but " nix" — his rounded verse being gen-
erally as glittering and as empty as a soap-bubble,
the whole charm of it consisting in the light in
which you may chance to view it.
Music, considered medicinally, may be classed
under the heads of sedatives, stimulants, and deriv-
ants, and these are dependent upon the form of the
medicine, the character and quality of the dose,
and the manner of its exhibition.
We find its earliest sedative influence in the
mother's lullaby, where its benefits are as conspic-
uous as those of Mrs. Winslow's Soothing Syrup,
and even pleasanter to take. In later years, " the
rain upon the roof," the trickling of the fountain,
the tinkling of a distant cow-bell, or the grand
diapason of Niagara's roar have equally soporific
effects.
As stimulants we see the best evidences of its
power in the energy which it gives to the soldier,
who thereby forgets the fatigues of a wearisome
march, and even the dangers of the threatening
fight; under its inspiration "his soul's in arms and
eager for the fray."
HOME MUSIC.
Practically, I believe a Steinway piano is a greater
nervine than is contained in the entire pharma-
copoeia— for without it the pent-up energies, the un-
called for mental and physical forces of the entire
American manhood would have no possible exit, and
the sex would be compelled to retrograde to the
horrors of the broom and other emblems of an effete
utility, or come to a speedy end by spontaneous
efflorescence. Most seriously, I think the physical
exercise and nerve exhaustion, or relief from ennui —
if you prefer another expression of the same idea —
obtained through the piano are the saving of the
entire sex from suicide or the lunatic asylum. Of
course, when I refer to the whole female sex I mean
the lilies of the field " who toil not, neither do they
spin," who are "clothed in fine raiment and fare
sumptuously every day." How many forlorn maid-
ens have poured out their wails in the responsive ca-
dences of a Chopin's nocturne, and the sympathetic
pedal has been the only recipient of the soft beat-
ings of many a stricken heart !
Indeed, the musician rushes to his favorite instru-
ment for solace in every trouble of life ; anger and
revenge, no less than ennui and despair, are soothed
by its magic power. Milton makes one of his char-
acters say,
" I was all ear,
And took in strains that might create a soul
Under the ribs of Death."
I doubt if many deaths of musicians by suicide
can be discovered, and among these few it will be
observed, I think, that most of them who sought
death felo de se, were temporally unable to find the
musical instrument from which solace might have
been attained. Of course the medicinal effect of
music is through the nerves, and its best results are
obviously upon diseases of the nerves themselves,
or of maladies directly attributable to their influence.
Accordingly we see that such diseases as St. Vitus'
Dance are especially affected thereby. In some of the
public squares of Paris the reveille in the morning
and tattoo in the evening at nine o'clock is regularly
beaten by a band of twenty-five to fifty drummers.
At this time it is customary to see some scores of chil-
dren, affected by this nervous disease, there attend-
ant, and their uncontrollable and discordant move-
ments temporarily quieted by the powerful rhythmic
influence of this strongly measured and regular
beating. A stranger, casually passing, might not
be sure that these children were thus diseased, un-
less he chanced to see them when the drumming
ceased, and this magic restraining influence was
withdrawn. The rehearsals of the boy-drummers in
the various arsenals of this city might be advanta-
geously utilized by those thus afflicted.
The nervous origin of many diseases is a fact of
modern discovery, and the nervous treatment of
these diseases is not yet fully understood. As for
example, a half century ago, and diabetes was con-
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The Medical Union.
sidered a disease of the kidneys. Twenty or less
years ago, the local lesion of the kidney was discov-
ered to be unimportant, and the result of overwork
of this organ. The actual disease was then traced
back to an imperfect action of the liver ; which, fail-
ing to do its work effectually, threw extra labor up-
on the kidney. Later still, the reason why the liver
did not do its duty was discovered, and to-day we
know that it arises from a deficiency of nervous en-
ergy and stimulus. Over-anxiety, business cares,
.mental toil and fatigue are now generally recognized
as the cause of diabetes.
A few years ago cancer was supposed to be the
result of a blow, and a complaint generally consid-
ered to be necessarily hereditary. To-day, while a
hereditary predisposition is recognized, we feel that
the determining influence is mental. Brain-toil,
worry of mind, family and business cares, and those
almost unbearable anxieties of life accompanying
failures, widowhood, poverty and suffering, are the
origin of such nervous disturbances that the func-
tions of the body are improperly carried on ; the
stomach loses its appetite, the food taken is imper-
fectly digested, badly assimilated, and the blood
becomes depraved and its nutritive powers dimin-
ished; and a resulting cancerous diathesis is thus
but the last link in a chain of circumstances of
which corroding care was the initial one.
Those honest persons, of however a puritanical
habit of thought, who see nothing but a prodigal
expenditure of money and a profitless waste of time
in the out-of-door concerts in the Central Park on
the Wednesdays and Saturdays of the summer
months, look at these recreations with a very narrow
understanding of their beneficent usefulness. For
myself, I believe that the weekly band-playing
in the neighboring Tompkins square is of more
worth than as many hundred tons of coal given
to the surrounding poor during the succeeding
winter.
Go down some day into the crowd gathered there,
reeking under the burning sun of many succeeding
torrid days. They have come from the garrets and
cellars of that populous neighborhood. They are
grim with toil and squalid with the rags of penury,
but they gather round the music-stand, and by the
exhilarating strains that are wafted thence they are
lifted out of their misery, they rise above them-
selves, and in a heaven of heavens they forget all
misery.
The German emigrant hears the familiar sounds,
" On the Banks of the Blue Danube," and the past,
both of time and place, comes back, swallowing up
the present ; the Irishman and the Scotchman see
again " Kathleen, "Mavourneen," or " The Blue-
bells of Scotland ;" and the native American's heart
beats with a new enthusiasm as " The Star Spangled
Banner " is borne far and wide by the breeze. Here
is food for after thought, and reminiscences for the
jocund whistle ; carking care is driven away, and
black melancholy is forced to avaunt, and quit the
sight of him whom misfortune has made to think
that all was dark around. As a pleasant word and
a cheering smile is a necessary accompaniment, and
often more welcome than the alms bestowed with it,
a city's charity should not consist merely of the
quarter of a ton of coal and the grocery order.
The public bath-houses, desirable as they are to
purify the bodies, are not all that is desired ; for the
purifying of the mind, the cleansing of the spirit,
the true lethean, which, while it produces forgetful-
ness of sorrow and pain, fills the mind with cheer-
ing thoughts, are equally desirable. It is not all of
life to live.
I would not underestimate the miseries of the
poor, but the few that suffer for the want of food
and warmth are vastly outnumbered by those who
are aching with grief of mind and penury of spirit.
We can make many of these sorrows forgotten, and
bring at least temporary oblivion to mental woes.
The perambulating hand-organ carrier — perhaps as
miserable as any — grinds out doleful charities, as he
turns many distracted minds to more cheering
reflections.
The capacity to enjoy music, in its various grades
of excellence from the simplest ear titillation to the
gorgeous sublimities of orchestral excellence, is a
matter of comparative education mainly. It is
therefore essentially proper that the first elements
should be taught, with other first elements of knowl-
edge, in our public schools. The degree of culture
wThich the State should gratuitously give its people
is a matter of proper dispute, but that some idea of
music should enter into its course, few will, I
imagine, question.
The sagacious man of business will not fail to
educate his children in the elements of music. Not
only will he find that his home is made thereby
more attractive to them — the song and dance taking
the place of more objectionable amusements — but
he himself will find his brain, muddled by figures,
wonderfully cleared up by his daughter's playing a
bit of Schumann or Beethoven, or his son's fine
voice ringing out in Blumenthal's " My Queen," or
like lyric gems. Indeed, if he wanted to make it a
business matter, he might figure the difference
between the cost of a Phelan's billiard table and a
Steinway grand, and then a second difference
between the degrading effects of the one, and the
elevating tendencies of the other.
But if the beneficial influence of music is thus
perceptible in health as a tonic, as a change from
the worry and turmoil of business as marked as
the effects of a change of diet, a change of air, and
a matter not for a summer or winter season, but
for daily use, if this is evident, how much more so
in sickness ! The sickness of the body is notably
greatly aggravated by the action of the mind. The
depressing influence of mental trouble often ren-
ders medicines almost powerless, while an unex-
pected pleasure sends a new glow throughout the
languid frame. At proper intervals the cheering
influence of music might be beneficially added to
the physician's tonics. There are often stages in
febrile diseases and other wasting complaints, where
life has hung upon a thread, where a cheering
thought, a tea-spoonful only, of some stimulant,
has kept the pendulum of life still swinging.
" Music ! 't is a generous wine !
As its sweet waves flow in our veins
Our hearts more lightly bound,
And our eyes shine the brighter."
From the French of Atiguste Bai-bier.
Potential as is this power, — which Gottschalk
calls "a psycho-physical phenomenon, in its germ
a sensation, and in its full development an ideal,"— ,
and especially powerful upon mental disquietudes, it k,
is astonishing that so little has been done to utilize its
cosmic force in the treatment of the insane.
The Medical Union.
267
MUSIC IN LUNATIC ASYLUMS.
It has been proposed that the musical bands which
occasionally play in the Central Park and our public
squares, should not be hired by the day or occasion,
but by the season, and that they should -play every
day of the week throughout the city. If this wel-
come statement is true, I suggest that once every
week — perhaps the rainy days, when out-of-door
playing would be profitless — they devote to the
insane poor at Blackwell's Island Lunatic Asylum.
The materialist may seek to account for the men-
tal phenomena of the insane, — as the instrumental-
ist the inharmonious sounds of his viol in the
gathering dampness or the contrary dryness, — now
finding effusions and congestions and membranous
inflammations and softenings of tissue, and with
this coarse and general knowledge he applies as
crude and uncomprehended remedies; but as he
is powerless to discover the thought in the tissue of
the brain, and as he is as ignorant how his medi-
cines act upon nerve tissue as he is how the galvanic
fluid transports metals and redeposits them, so is
he ignorant how music calms, amuses, and cures.
The great Schiller, in words translated by Arthur
Matthison, thus beautifully says :
" Where'er throughout this mundane sphere,
With dulcet tone, fair Music lifts her voice,
As by enchantment, from the human heart,
She bears away its pangs;
Celestial attributes she owns,
And unto man, with heavenly sounds,
Recalls his immortality.
Thoughts born of earth no more oppress his heart;
O'er his rapt soul she pours the oblivious wave ;
His sorrows melt, and in his wounds, with grace divine,
She sheds a pure and holy balm! "
If you will go into the squalid tenements, where
poverty stays, not lives, the " application " will sug-
gest itself to every heart. Mount up to the garret
chamber; your way will be perhaps impeded by
a group of children gathered upon the stairway and
singing with infantile voices the songs they have
learned in the primary school or the Sunday
schools. They care little for the words. They
may shout out, with those delicious child-tones,
sweet as spring violets, that ' ' they'd like to be an
angel," but it is not true ; they don't want to be, nor
does any one else that I ever knew, unless anything
was better than the suffering they endured. But
they are not more responsible than is a parrot for
swearing. Those little melodies cheer the parents'
hearts and sweeten their toil, and their shoemaker's
hammer or needle is plied the faster, and at the
same time less laboriously, keeping time with the
jocund song. In coming years these carols shall
act as medicine to their own mental disquietudes.
Whether rich or poor, these songs of childhood
shall come back to the weary and suffering, sou-
venirs of youth and its coadjutant joys, of child-
hood's innocence and unsuspicious youth. They
will float in the dreamy visions of the uneasy pillow,
and they will bring forgetfulness of attending woes.
MUSIC IN SCHOOLS.
Believing this, is it not our duty to encourage the
I education of the children in the public schools in
this aesthetic branch of knowledge ? Is it not our
duty to see that it is also taught efficiently, and by
that I do not mean profoundly. We do not ask for
instruction in thorough bass any more than in in-
strumental tecnique, but we especially wish that the
music appropriations be not devoted to enriching
piano-makers, in commissions to piano-buyers, nor
for a sinecure to some partisan politician. Nor
would I have the teachers mere musicians. An
arithmetician may have for his aim simply to teach
figures for so many hours for so much money ; but
he who teaches music in the public schools to-day,
with the present general erroneous view of its dig-
nity, its elevated aim, and its holy object, should
be imbued with the lofty feelings which should ani-
mate the colporteur and the missionary of the cross
of Christ. Music — the only language common to
earth and heaven, the tongue of angels employed
in the service of the Most High God — its teachers to
sinless infancy — to the poor in health, in means, in
spirit — these teachers should be no mere hirelings,
hurrying through their brief hour, to speedily re-
turn to their haunts in the adjacent lager bier
cellars !
Would that we had more Orphean schools among
us ! Would that we had more men imbued with
the self-abnegation and high moral aim of Jerome
Hopkins ! for in this connection his name may be
deservedly spoken in honor.
And here, perhaps, it may be well to reply to
questions that I have frequently been called upon to
answer professionally, and these questions refer to
the local effect which is produced upon the organs
especially engaged in the production of the musical
sounds themselves.
SINGING WITH WEAK LUNGS.
" Do you recommend singing to those who prob-
ably inherit consumption and asthma?" " Are dis-
eases of the heart aggravated by blowing hard in-
struments ? " " What is the effect of vocal exercise
upon children, 'pigeon-chested,' or otherwise de-
formed? " " Should those affected with diseases of
the throat, tonsils and other appendages, having
catarrh, etc. , play upon wind instruments ? "
General questions require general answers, and
therefore without entering categorically into the
consideration of these queries, it may be said that
the great strain in singing and the blowing of
hard instruments is not so much upon the lungs
themselves, as upon the intercostal muscles, and
the large pectoral and other muscles covering the
ribs and the diaphragm, etc. , below. It may be
well to remember the general fact that the powers
of the body are strengthened b}' proper use ; and
that more especially the blood should be kept circu-
lating through the lungs ; and that by active use, its
impurities should not be allowed to collect and
stagnate in its unused portions, as the dust and
debris gather together in the nooks and corners of
large apartments in our houses but partially occupied.
Even where there is serious local affection, abso-
lute rest is not always essential, and the certain
death that was the necessary result of an incurable
disease did not seem to be hurried by the daily
professional labors and serious exertions. Not only
have I known music-teachers (who might be able to
save themselves somewhat) but those taking the first
operatic parts and many orchestral players on flute
and clarionet, able to perform their nightly labor until
prevented from so doing by general debility rather
than from incapacity of the diseased lungs them-
selves,
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The Medical Union.
In most diseases of the throat and bronchial
tubes, singing is contraindicated, for here there is
incapacity as well as inadvisability.
There is a moral result to be directly ascribed to
musical study. The lover of music, habituated to
glee or choir singing, is thereby not only a good
citizen, but necessarily attains to a juster apprecia-
tion of himself, of life and its requirements. He
finds his part written out for him upon the pages of
his music book, and this part he must follow hon-
estly, truthfully, unflaggingly, unswervingly. He
sees the necessity of undeviating rectitude and
prompt execution of his duty. He cannot deviate
from the correct note, or painful discord is the re-
sult ; he cannot fail to keep his time correct, or in-
evitable disturbance is the consequence. In after
life, in his business arrangements, these musical
necessities translate themselves into the business
maxims of honesty and probity. The good " time-
ist," will be prompt to his business appointments,
well knowing how his failure to " come in" at the
proper time, will " throw " all the others concerned
" out. " The man who takes his notes clean and with-
out wavering, true to the tone, will have no business
notes protested ; you will not find his key to be one
flat, nor will he, thus imbued with correct views of
life's duties, attempt to " come it sharp " over his
fellows.
Finally, the musical instruction of his youth will
tend to give him a correct appreciation of himself
and his capacities. He recognizes his natural limita-
tions ; if his voice is tenor, he has learnt the futility
of trying to sing bass; if his voice is limited he will
not attempt to squeak up to the C in alt, so glorious
as it is in its clarion ring. Such a man thus taught
is not found among the droning bores of prayer-
meetings and Sunday schools, nor is his voice
drowned by the impatient audience of political or
other meetings. He has early learnt his powers and
that his path of life is limited by his natural capaci-
ties.
Macready asked an actor, in the words of Hamlet,
"Canst thou play upon the lute?" The stupid,
forgetting the proper answer in the naturalness of
the enquiry, replied, " I don't know, but I can try."
One of the most valuable parts of learning, is to
know what one cartt do. Some gruff-voiced men
never learn that they can't sing treble or tenor.
Such men who never know their capacity, are blun-
dering through life; brought up farmers, they try to
run a locomotive ; shopkeepers, they try to keep a
hotel ; country-loungers, they accept any office that
their uncle, the senator, can get for them; and
thus our custom-house officials, our consuls and for-
eign ministers even, are filled by incompetent per-
sons. These men who never learnt their musical
part in youth, who never learn that a square
plug will not fill a round hole, are those who were
brigadier generals in the late war — the "accidental
sharps " among our collectors — or that astute band-
leader who prided himself on his economy. He
said, "when he had a piece written in five flats, he
never used but three of them."
Pertinent to this train of thought is the prospec-
tive action of the Board of Education. The Presi-
dent (who, by the way, has no business to be a
member of the Board, while there are so many
natives capable of properly filling the situation,
inasmuch as he, if now a citizen, was not even an
inhabitant of the State a year ago — but he is a
finely-educated, finished gentleman, and every way
an efficient man), Dr. Holland, is fully imbued
with the idea not only of teaching children mu- ^
sic, but also of teaching by music, as the drill is \_
taught by taps of the drum or the bugle-call. Geo-
graphy and morals, philosophy and arithmetic are to
be musically drawn into the memory, in the train
of some jolly tune, which shall have the same rela-
tion to the thought as a locomotive whistle has to
a baggage car.
At the head of this is to be a musical superintend-
ent to direct the instruction in all the schools of
New York. What a sphere of usefulness is here
opened ! What a chance for immortality by doing
a good work ! Is there a man capable of prop-
erly doing this' work ? Is the individual to be
found whose thoughts go beyond the salary to the
inauguration of a new path for instruction — to self-
forgetfulness and toil ? Is there a man extant, pos-
sessing a knowledge of elevated music, who will not
pander to the low taste that sees no music save in
negro minstrelsy ; to the puritanic severity that sees
nothing lofty except in psalmody ; to the hyper-
critical, that is content with the fossil era of Bach's
fugues ; to the enthusiastic dreamer in the music
of the future ? Is such a man to be found, practical
and authoritative, having confidence in himself and
inspiring it in others ? To such a one let us lend
our support ; to the plan itself let us render every
assistance. There is no reason why instruction
should not be made pleasant. We cut off one's leg
while in a dream of delight ; we pull out one's
teeth as he lays lapped in elysium. If we can
drill the multiplication table and fractions into the
brain by the tactics of " Captain Jinks of the
Horse Marines," and all geography is to be
found ."In Dixie's Land," there will be little play-
ing hookey, and parental indulgence will grant few
excuses for shortcomings.
Now, ladies and gentlemen, I am done. If I
have failed to place music as a necessity to man in
a physical as well as moral and aesthetic point of
view, believe it owing to the limited capacity of the
speaker rather than any want or deficiency in the
subject. It is the delight of youth, the stimulant
of maturity, the solace of age, the panacea for every
ill, the medicine to all.
Oh, Harmony ! the God's dear gift to man,
How thrills my soul at thy supreme command !
How to my heart thy liquid numbers speed ;
Thy many tongues of beauty speak,
And sweet discoursings make of joy celestial !
Spread thy resplendent wings,
Bright child of Heaven ! .
Float through the listening air,
And, with benignant voice,
Breathe thy rich blessings o'er the longing earth !
Children of earth ! hear ye the song divine,
And grateful thank all-bounteous Heaven,
Who gives ye music !
— From the Italian of Montelli, translated by Arthur
Mattison.
237 East i^th Street.
The Connecticut (Allopathic) Medical
Society has appointed a board of censors, whose
business it will be to examine candidates for admis^
sion to the medical school. In future, something
more than a good common-school education will be
required.
The Medical Union.
269
THE PATHOLOGY OF CERTAIN DEFORMITIES
OF THE EXTREMITIES.
?
By George H. Taylor, M. D.
The deformities which are the subject of the
present inquiries may be ranged under the follow-
ing heads :
Permanent muscular contractions, producing flex-
ion of joints with restricted or entire loss of motion.
The contraction is caused by morbid nervous
stimulus, derived from diseased nerve centres. The
deformity thus occurring, is liable to become per-
manent, for reasons hereafter explained.
Deformities every way similar, produced by the
shortening which occurs in atrophied muscles caused
by some obscure fault in the nutritive system.
Deformities caused by a prolonged fixed position
of joints, whether flexed or extended. Continued
fixed position is sometimes rendered necessary by
great weakness, preventing due motion of moving
parts. Rigidity of position is sometimes enforced
by local ailments, resulting in loss of power and
deformity.
Deformities produced by cicatricial contractions,
following wounds or abscesses in the vicinity of
joints.
Deformities produced by rheumatic inflammation,
through its effect both on the tissues and mechani-
cal co-adaptation of the parts composing the joints ;
and also, by its effect on the muscles and areolar
tissues which are related thereto.
Deformities caused by infantile and by adult par-
alysis, whenever opposing muscles lose their equi-
poise; extremities are thus caused to diverge by
yielding to the action of the stronger muscles.
It will be seen that the above causes -include a
large majority of deformities to which the extremi-
ties are liable.
It is not the purpose of the present inquiry to
include only those milder cases necessitating the use
of crutches and other assistants to locomotion, but
also those cases that are absolutely and perman-
ently helpless, for which braces and supports have
been found to afford no aid, and for which tenotomy
and other resources of surgery have also proved
useless.
It is my desire to present for the consideration of
physicians and others, certain principles in the
pathology of these cases which have hitherto been
neglected ; to adduce most satisfactory evidence of
their importance as guides in practice; to show
their great value and their availability in securing
restoration, even of cases which must otherwise
remain permanently deformed and helpless.
It is also important to show, what it ought to be
unnecessary to show viz.: that the treatment based
on the exterior manifestations which constitute
deformity, is practically, as well as theoretically, far
inferior to that which is founded on the real inteiior
condition of the tissues involved.
What anatomical ele7nents are involved. — One
element of disability lies in the joint proper. This
may have suffered from inflammation, more fre-
quently of the rheumatic variety, by which the
coalition of parts has become deranged, or a prod-
uct of inflammation offers a mechanical obstruc-
tion to motion.
Another element of disability consists in the
retraction and shortening of both muscles, and of
areolar tissue, and a suspension of the active, work-
ing power of muscles. This compels the joint to
remain in a fixed position, usually at some angle.
Still another pathological consideration is in-
volved in a large number of cases. This is, the
diseased condition of the nerve centres, which stimu-
lates, impels the muscle to contract. But, since
this condition, and the principles and methods ne-
cessary for removing it, are fully discussed in my
work on "Paralysis," I shall omit in this plan
further reference to this department of the sub-
ject.
From this statement of causes, it will be inferred
that the problem presented for solution in cases of
deformity is far more complex than usually enters
into the computation of the physician, surgeon, or
orthopaedic specialist. For if the original and
causative affection exists in the spinal or cerebro-
spinal centres, it is not enough to remove the cause
there located, but those effects which have become
secondary causes. These are, loss of muscular nu-
trition and muscular substance ; the loss of the me-
chanical properties, not only of muscle, but also of
the areolar tissue, which in some of its forms serves as
the connection between muscles and osseous frame,
and through which all locomotive power is trans-
mitted.
If the cause is referable to some local malady of
long continuance, still the effect, so far as locomo-
tion is concerned, is not remedied by the removal
of the causative affection. There still remains the
fixation of joints and the immovability of muscular
and areolar tissue, which often defeats the best efforts
of skillful physicians to restore. Even if he con-
siders properly the mechanical nature of the impedi-
ment to restoration, the practical adaptation and ap-
plication of the direct means for its removal, he has
neither the patience nor skill to apply; but is
usually content to recommend supports and other
mechanical palliatives.
If the cause lies in some vitiated condition of the
blood, giving rise to local manifestations, as in rheu-
matism or scrofula, the physician is ordinarily at
loss for means for removing the swelling, the adven-
titious tissue, and of restoring both suppleness and
power, after his skill has fully subdued the primary
cause.
Condition of muscle, in permanent contraction. —
He must understand the structure and action of
healthy muscle, in order to fully understand its
wants in disease.
Muscle is made up of bundles of fibres, and these
again of smaller fibres or fibrille j this last is com-
posed of a longitudinal arrangement of ultimate
muscle-cells. The act of muscular contraction, as
when an arm is moved, consists in the change of
shape of the cells of fibrillar, these cells being
flatter and broader. A portion of the cells only of
a fibril contracts at the same time ; each contrac-
tion is succeeded by relaxation of the same cells,
while others engage in the act ; so that muscular
action really consists in the change of shape, the
alternate flattening and lengthening of a multitude
of cells joined endwise.
The normal action of muscle is controlled by
nerve stimulus. The degree of rapidity and the
extent of action depends on the energy derived
from nerves. But, after being for some time in-
terrupted, the muscles lose their obedience to the
stimulus. There is diminished contractile sub-
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The Medical Union.
stance composing the muscle, and there is an indis-
position on the part of cells and fibres which have
been long in contact to allow the contact to be
severed. There is evidence that tissues thus cir-
cumstanced become adherent. The fact that when
exterior mechanical power is so adapted to over-
come and sever such adhesion, power is soon
regained, is quite conclusive in this direction.
The absence of functional duty on the part of
muscles is always followed by deterioration of sub-
stance, whether this absence is caused by with-
drawal of nerve stimulus or any other of the causes
cited. The shrinkage of muscle-cells shortens the
muscles which they go to form. This effect takes
place with greater rapidity than is usually imagined.
The partial disuse of the leg caused by sciatic pain
rapidly softens the flesh and diminishes the circum-
ference of the thigh one or two inches in a few
months. In a case of a rheumatic affection of the
knee, which had continued ten months, the leg
measured two inches less than its fellow, and the
difference in degree of solidity was conspicuously
evident. In infantile paralysis, the muscles often
waste away. to mere cords.
The shrinkage of muscle-cells, inevitably con-
nected with non-use, shortens the muscles. But,
since the opposing muscles of an extremity are not
of an equal power, those having most power neces-
sarily overcome those of least, and then results
actual diminution of length only on one side. This
permanent contraction necessarily causes the ex-
tremity to which such muscles are attached per-
manently to diverge, and the joint to be fixed in a
bent position.
In case of spasm from nerve irritation, the mus-
cular contraction occurs first, and the lack of control
causes the deformity to become fixed and perma-
nent. Indeed, there are many modifications of the
process of contraction, but all end in one uniform
condition — permanent shrinkage, loss of contractile
power and of the normal interchange of matter
which constitutes muscular nutrition.
Sometimes the loss of the substance contained in
the muscle-cell is replaced by fat. The lack of
power in this case is the same as before, but there is
usually no shortening. The fatty condition of the
muscle does not, however, require a different
treatment, but is fully amenable to those curative
processes which restore muscular nutrition and
growth.
Condition of areolar tissue in deformities. — The
morbid condition of the muscles is, however, but
one element in the pathology of deformities arising
from contraction. Contraction of the areolar tissue
presents a far more formidable obstacle.
The muscles are interpenetrated and sustained
by an intimate network of areolar tissue, consisting
of interlacing elastic fibres. Toward the ends of
the muscles these fibres become condensed and ad-
herent, and finally connect the muscles with bones,
and thus serve as the medium for the transmission
of power. The vessels and the nerves are also sus-
tained and protected by the same tissue.
The function of areolar tissue is eminently me-
chanical, and is variously expressed. The network
described as investing and interpenetrating the
muscles while sustaining them, readily yields to all
motions caused by muscular contraction. But the
elasticity of this tissue acts like a spring in aiding
to restore the contracted muscle to its original posi-
tion. This action involves to a large degree the
gliding of the fibres of this tissue upon each other,
whenever they are in contact, whether parallel or
crossing each other at whatever angle. It is hence
evident, that this capacity of gliding in every direc- \
tion of all fibres in contact, is an essential property
of areolar tissue, without which little, perhaps no,
movement of the extremities would be possible.
Intermingled with the smoothly gliding fibres,
there is also another kind, — the elastic fibres.
These fibres increase the elasticity of the tissue,
and aid more completely to effect the restoration of
displacement caused by every muscular movement.
The gliding of fibre is also necessary as regards
this as other forms of tissue.
The importance of these properties of areolar tis-
sue to the mechanical functions of the body and its
parts cannot be overestimated. The loss by the
fibres of this tissue of the property of freely and
smoothly gliding upon each other and upon the
muscular fibrillar with which they are in constant
contact, involves nothing less than the suspension
of mechanical function, — involving nothing less
than the power of locomotion. The action of the
too feeble muscles is effectually blocked ; perman-
ency of form succeeds the elasticity which charac-
terizes animal tissue endowed with full vitality. The
joints are allowed to become rigid in a fixed posi-
tion.
The loss of function of the areolar tissue inevita-
bly takes place in all cases of deformity with ab-
sence of motion. But in many instances, there is
an additional complication, putting the case still
further beyond the reach of ordinary remedies ; or
rather, relegating it to the control of the sole rem-
edy adapted to the case. The condition now re-
ferred to is the adhesion^ sticking together, or
agglutination of the interlacing fibres, and adhesion
of these fibres to muscle. In case of rheumatism
producing deformity, such adhesions and agglutina-
tions are quite evident. The effusion of plastic
material, which is the constant product of this in-
flammation, serves as a cement, binding together
all the fibres in the inflamed region. In case of
cicatrices, a similar agglutination of fibres is pre-
sumable, and for a similar reason. In this case,
also, the loss of muscular substance resulting from
abscesses, etc., produces a closer approximation and
condensation of the fibres of this tissue, which
causes shrinkage and the deformity which charac-
terize repairs of- tissue in general.
But joints become fixed and immovable in the ab-
sence of every sign of inflammation. It is only nec-
essary that there shall exist a degree of weakness
which prevents the employment of muscle during a
considerable lapse of time ; in some cases, years are
required. Under these conditions the muscle-cell be-
comes shrunken, the areolar fibres refuse to yield to
treatment, the elastic fibres become rigid ; and if these
several kinds of fibres have not become adherent, they
at least comport themselves as though they were
joints related to fibres that have lost their several
distinctive functions, are rendered useless, flexed,
and immovable. The absence of spasm and of
previous inflammation is no guarantee that inter-
lacing fibres are not adherent ; while the absence of
the power of motion, and the restoration of such
power on supplying the remedy solely adapted to re- /
move this special obstacle, affords proof that adhe-
sions existed.
The Medical Union.
271
In the deformities caused by infantile paralysis, or
the paralysis of growing children, substantially the
same mechanico-pathological difficulties are pre-
sented. There are, besides, others added, arising
from diminished growth of the paralyzed parts.
This allows the non-paralyzed muscles to gain more
power, which, not being counteracted by the op-
posing muscles, not only cause the extremity thus af-
fected to diverge, but sometimes the bone itself
yields to the strongest pressure and becomes
moulded to abnormal shapes. Another difficulty
occurring in these cases is the substitution of fatty
matter in muscle-cells giving a fictitious appear-
ance of muscles where they do not, in fact, exist.
We have now arrived at a definite conception of
the obstacles which it is necessary to remove in or-
der to remedy the kinds of deformity under discus-
sion.
The work to be done to effect restoration may be
stated as follows :
To restore muscle-cells to their normal size by in-
creasing their nutritive activity. In acquiring vol-
ume, muscles are also increased in length and
in power to move and control the joints of defect-
ive members.
To sever attachments and break up adhesions of
contiguous parts ; and restore the gliding motion of
the separate fibres of areolar tissue, thus rendering
it perfectly elastic and yielding to the slightest mani-
festation of muscular power.
To secure the removal of those effused matters
which constitute swellings.
To cause absorption of the fatty matters con-
tained in muscle-cells, and the restoration of their
normal constituents.
Self-evident as are these statements of principles,
our orthopaedists appear to derive no practical sug-
gestions from them. Neither have physicians seen
fit to criticise the methods pursued by surgeons and
specialists in deformities, or in any way shown that
there are important vital as well as mechanical in-
dications to fulfill, and that the latter must always
prove insufficient while the former are neglected.
To render my meaning more clear by contrast,
it is proper to advert to current practice in deformi-
ties produced by contractions. The orthopaedist
seems generally to regard these deformities in just
the same way as they appear to the eyes of rela-
tives and friends of the sufferer, viz : as presenting a
mere mechanical problem for solution. The truth,
as all have seen, is, that these difficulties are based on
defects of a vital nature, and will find their true
remedy in the correction of vital action. The cura-
tive method usually dictated by this imperfect and
inadequate conception consists in extension, or di-
rect pulling in the longitudinal axis of the extremity.
Of course, a multitude of different devices calculated
to effect the object is possible, and the chief difference
of treatment supplied by different orthopaedists is
nearly limited to varieties in devices to carry out this
idea of mechanical extension.
It is plain that if the therapeutic indications are
such as have been above pointed out, mechanical
traction can do very little toward responding to
them; that is, vital structures which subsist
and act through interior changes should not be
treated like inanimate, extensible, homogeneous ob-
jects. There may possibly be forced external con-
formity, but not internal recovery. Neither muscle,
nor areolar tissue, nor tendon are, as such, even
sought to be benefited. The cells of the former
remain shrunken, in spite of extensory forces, and
though areolar fibres be ruptured, their gliding
property is not thereby improved. The elasticity of
fibres is prevented rather than increased by the
continuous strain of stretching. The instruments
required for the purpose of extension are liable to
compress circulatory vessels, and to hinder rather
than promote the access of blood. It hence ap-
pears that recoveries which follow treatment by
simple extension are not its direct effect, but indi-
rect and secondary, requiring a great deal of time.
A very simple illustration will perhaps aid the
comprehension of the relative curative value of the
,two methods now brought into comparison. One
end of a cord being made fast and immovable, if
one makes traction at the other end, the fibres of
which it is composed are compressed firmly to-
gether by the act of pulling ; they are caused to
coalesce and offer united resistance to the force thus
applied. The cord stretches but slightly, the fibres
nowhere yield ; and on relaxation of the force ap-
plied, the cord has suffered no damage ; it is ex-
actly as before the experiment. It is only by using
great power that the cord is broken.
If we really desire to weaken the power of re-
sistance without destroying the individual fibres of
the cord, we pursue with it a course exactly oppo-
site. We separate the fibres, by applying power
at right angles to their longitudinal axis. The
effect is seen by slightly untwisting. The fibres
now glide upon each other with the utmost facility;
they act independent of each other; they no longer
coalesce; their power of resistance vanishes, and
they readily yield to any opposing force.
The remedy for an infirmity should bear some
philosophical, not to say intelligible, relation to it.
While forcing an apparent and external conformity
to the needs of a case of deformity from contrac-
tion, the very pertinent inquiry respecting its sub-
jective needs, remains unanswered. But the sub-
jective or interior requirements are the really
important ones — in fact, as relates to treatment,
almost the only ones. Vital development, activity
of muscle, facility for ingress and egress of blood,
perfecting of local nutrition — these are certainly
not any direct results of traction and confinement.
Elasticity, yielding and gliding of fibres, are abso-
lutely prevented by this species of interference.
The true and direct remedy can only consist of
such means as most completely and directly reme-
dies defective local nutrition, and which secures
separation and separate action of interlacing and
adherent fibres.
There are, however, certain compensating ad-
vantages in the treatment of contractions by sup-
ports, especially in cases of the lower extremity.
The instrument serves to continue the extremity to
the ground, thus placing the parts in a more natu-
ral and desirable position, and, spite of above-
mentioned difficulties, strength is sometimes slowly
gained, and recovery rendered possible. The in-
strumental treatment is often better than none,
since effects desired are acceptable from indirect
sources, when the direct is unattainable.
To facilitate instrumental extension of contracted
muscles and flexed joints, the severing of the ten-
dons which connect the muscles with the osseous
frame is not unfrequently practiced. This opera-
tion is, in general, quite unnecessary, as the method
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hereafter described is much more than a substi-
tute. The operation of tenotomy neither aids de-
velopment of muscle nor facilitates areolar divul-
sion, but prevents both, at least for a time. It is
also less certain to secure straightening of limbs,
and when comparatively successful is slower in ac-
complishing the object.
A CASE OF MEMBRANOUS CROUP IN AN
ADULT.
By Henry F. Aten, M. D.
Mrs. G., ast. 23, six months advanced in preg-
nancy, sent for me on the 19th of April, 1869, to
treat her for what appeared to be a severe cold.
I found her very hoarse, with a severe metallic
cough, high fever and great thirst, with soreness
of the larynx and windpipe. On examining the
throat, there was no inflammation of the fauces.
I prescribed Pot. Bichrom. and Aeon, in alternation.
On the next day the condition of the patient was
much worse. There was complete aphonia, and
on examining the throat the epiglottis presented
a membranous deposit. I saw then the nature of
the difficulty I had to deal with, and apprised the
family of the danger attending it. Continued the
same remedies. Saw her in the afternoon of the
same day, when there was great difficulty in breath-
ing, and the membrane could be seen more dis-
tinctly upon and around the epiglottis. Made no
change in the treatment. On the morning of the
2 1 st she had passed a piece of membrane as large
as a ten-cent piece. Gave Stib. and Pot. Bichrom.,
with an occasional dose of Aeon.
April 22d. A few more pieces of membrane were
set free, with considerable relief following there-
from. Continued remedies.
23d. No material change.
24th. As I entered the room I was handed a
piece of membrane 2% inches long by 3% inches
wide, presenting the impressions formed by the
rings of the trachea. This had been expelled by a
severe fit of coughing, after which there was great
relief in breathing, followed by speedy convales-
cence. Altogether, this was one of the most inter-
esting cases it has ever been my fortune to observe.
How much of the favorable result was directly due
to the agency of the remedial measures made use
of, cannot possibly be asserted ; but it is fair to
infer from present knowledge concerning the ac-
tion of the remedies, or principal remedy used
(Kali Bichrom.), that much of the result -was due
to medicinal action. A feature of the case worthy
of note was the entire loss, of vocal power, the
patient losing the ability to sing, which she possess-
ed in a marked degree previously. At her confine-
ment, however, which took place three months
afterward, she regained her voice to a considerable
extent, and is now in the enjoyment of excellent
health. Of course, I was careful to preserve the
membrane, and it now occupies a prominent place
among other specimens in my office.
34 Hanson Place, Brooklyn.
Hemorrhoids in Parturient Women. — A
writer in a French journal recommends the applica-
tion of a lump of ice inclosed in a bag of rubber or
goldbeater's skin, and renewed as often as it melts.
A CASE OP CHEMOSIS CURED BY GUAR£A.
By Abel Claude, M. D.,
Late Chef de Cliniqne, Hopital St. Jacques, Paris.
X , a porter, sixteen years old, lymphatic
temperament, subject to bad hygienic influences,
called upon me on the 5th of October last with
chemosis of the right eye, which had existed for
about twelve hours. The swollen conjunctiva was
of a brilliant red, with a purplish tinge, elevated
into a kind of roll or cone around the margin of the
cornea, and, surrounded by this swelling, the dilated
pupil looked like a dull black spot. It was impos-
sible to invert the upper eyelid, so great was the
oedema. A sero-purulent discharge ran from the
eye in such quantities that two large handkerchiefs
were saturated with it during the morning on which
he came under my care. At this time there was no
pain and no fever, although during the previous
night he had suffered terribly with shooting and
tearing pains in the eye, frontal cephalalgia and
intense thirst. These symptoms, however, had dis-
appeared ; he was able to bear considerable pressure
on the eye, and the sight was unimpaired.
By questioning him very closely I found that for
two months he had been suffering from an attack of
acute blennorrhagia, with a profuse greenish dis-
charge, painful micturition and nocturnal erections.
The lymphatic glands in. the groin were slightly
enlarged, and likewise those extending from the
knee to the scrotum, but there was no evidence of
syphilitic infection. The patient was so filthy and
ignorant that I concluded the case to be one of
self-inoculation from. the urethral discharge, although
I had no direct proof of the contagion.
I was compelled to assume this hypothesis, since
I could not consider it a case of metastasis while the
blennorrhagic discharge was still existing. The
blennorrhagia held the same relation to the chemo-
sis, in my opinion, as a cause to an effect, and con-
sequently the prognosis was unfavorable.
We know the. barbarous treatment adopted in
these cases by the old school — large, general and
local bleedings, scarifications, punctures, vesica-
tions, purging, vomiting and mercurial frictions.
Fortunately, I remembered the treatise on Guartza
by Dr. Petroz, who has so admirably deduced the
clinical indications which are to be learned from
the pathogenesis of drugs, and I prescribed : Tr.
Guarsea, gtt. v.; Aquas distil, f v. Tea-spoonful
every two hours.
I likewise ordered a compress of cold water to the
eye and the use of a suspensory bandage.
October 8th, X came again. The cure of the
chemosis has been complete since the 7th inst., and
no swelling or vascularity of the conjunctiva can be
perceived. A peculiar condition, however, has been
left. There is a perceptible diminution in the
natural volume or size of the eye, and the relative
proportion between the two eyes is so apparent that
the patient himself, stupid and unobserving as he is,
called my attention immediately to this remarkable
effect.
The etiology of this chemosis, which was so
rapidly overcome by the Guartza, induced me to try
the same remedy for the urethral inflammation, but
without any effect. At the end of a week's trial I
resorted to the ordinary remedies, and, under the
The Medical Union.
273
use of Cannabis and Cantharis in alternation, the
patient was finally cured. At the end of a month
the discharge entirely ceased, and my patient was
well.
Subsequently, I made some researches in the
Etudes de Therapeutique, which my excellent mas-
ter, Dr. Cretin, erected as a monument of filial
devotion to the memory of Antoine Petroz, and I
found there a case of traumatic chemosis which
occurred after the operation for cataract, and was
cured by the twelfth dilution of Guarcsa. Conse-
quently we must admit the perfect homceopathicity
of this drug, which, in two cases, similar in their
symptoms, although contrary in their origin, pro-
duced the same happy result, notwithstanding the
posological difference in its use.
THE USE OF SPIRITUS TEREBINTHINjE BY
. INHALATION.
By L. Traneus, M. D.
Notwithstanding this drug has long been in
use both empirically and homceopathically, yet its
provings have never been as full and satisfactory as
could be wished or as its merits warrant. In com-
paring the different authors on Materia Medica we
generally find the following effects given as the
leading ones, viz :
1. The ganglionic nerves of the uro-genital sys-
tem whose mucous membranes are involved.
2. Both the ganglionic and the sensomotorial
nerves of the whole intestinal tract.
3. The sensitive nerves of the head.
4. Several nervous diseases of a chronic char-
acter.
5. The skin — by external application.
6. The lithic-arthritic diathesis.
7. Against intestinal worms.
Besides these, certain authors give some vague
hints as to the use of turpentine in pulmonary dis-
eases. It is in accordance with this that a new and
broad path has been opened by the experiments
made by Prof. Huss in Stockholm, Sweden, about
1858 and the following years. He commenced to
use the Spir. Terebinthinae consequentially in all
cases of chronic or adynamic inflammation of the
lungs, thus : In the grey induration, chronic bron-
chitis, infarctus, pulmonary gangrene, and those
cases of typhus and typhoid fevers where the lungs
were deeply involved. It is to be observed that the
medicine was administered in the large doses char-
acteristic of allopathy a decade since. Yet the suc-
cess of the treatment led me for several years to
administer the turpentine by the way of inhalations,
which have always proved successful. Now the
question may arise, is the action of turpentine to be
regarded as opposing any disease of the lungs, — allo-
pathy,— or does it act according to the law of similia
similiis? According to the above statements, as
drawn from all experience, the turpentine is irrita-
tive to all the mucous membranes, and also to all of
the eliminatory canals of the larger and smaller
glandular organs. Thus it irritates the epithelial
lining of the nasal cavity, the throat, the larynx,
and the bronchia to their extreme terminations as
air-vesicles, which are formed of a thin membrane
of elastic tissue, covered by ciliary epithelium
{"Flitnmer-epithelium "). Nearly all these mucous
membranes contain elastic tissue ; they are likewise
nearly all covered with the same kind of epithelium.
We may therefore conclude that the same medical
agent must have a similar effect on surfaces which pos-
sess the same anatomical formation. Indeed, turpen-
tine must be rationally regarded as homoeopathic to
diseases of these organs. The above-reported method
of its use by Prof. Huss was not homoeopathic, but
the modification of it by inhalation, which I have
brought into practice, may be so regarded, as the
gas of the Spiritus Terebinthinae is spread out over
an immeasurably extensive surface by the inter-
stices of a sponge or the minute filaments of cot-
ton, etc. In this way it is thoroughly diluted with
air, so as to be easily inhaled, thus producing a
local irritation, which may be requisite to arouse the
slow reactive power of the inflamed mucous mem-
brane. From another point of view — if we con-
sider the lungs as secretory organs, as possessing
the same anatomical structure as the salivary glands,
etc., and the bronchia for their eliminatory canals —
we will arrive at the same conclusion. For turpen-
tine, given in large doses, has been found irritating
to such glandular organs and their excretory canals.
Thus it acts homceopathically, if used in diseases of
those organs.
As to the manner of using Terebinthinae in these
conditions, it may be added that a common smok-
ing pipe of chalk, which has never been used for
tobacco, affords the best apparatus for these inhala-
tions. It should be filled with a small sponge, or
with cotton, and about a tea-spoonful of Sp. Tere-
binthinse should be put upon it for the imbibition of
the sponge or cotton. It is not to be lighted. The
patient, placing the pipe in his mouth, draws deep
and long inspirations, whereby the gas of the tur-
pentine, together with the air, fills the air-tubes and
penetrates into the air-vesicles of the lungs. In
inhaling it a rather agreeable taste of resin will be
noticed, together with the fragrance of violets.
Occasionally at first the inhalation provokes slight
coughing and expectoration, which soon subsides,
and rapid improvement usually speedily follows
under its administration. It should be used from
three to six times every day.
227 Atlantic Avenue, Brooklyn.
RESEARCHES IN REGARD TO THE
RESPIRATION.
By Ernst Lockenberg,
With the assistance of Professor A. Fick, at the
Physiological Laboratory, Wiirzburg.
Translated and Condensed by William N. Guernsey, M. D.
Many experiments have been made by renowned
scientific enquirers to determine the relations of
the pneumogastric nerve to the respiratory move-
ments, although as yet without having attained
corresponding results. Not long ago, indeed, the
various authors held diversified and clashing views
upon this subject.
While some claim that upon irritation of the
central end of the divided vagus the diaphragm
always assumes an inspiratory position (Traube,
Kolliker, H. Muller, Snellen, Lindner, Lowisohn,
Bernard, Gilchrist, Funke, Schiff), others assert it
274
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to take that of inspiration (Eckharrdt, Budge,
Owsjaunikow), and yet others that it assumes either
the position of inspiration or of expiration, accord-
ing to the strength of the current applied (V. Hel-
moltz, Aubert, and Von Tschischwitz).
J. Rosenthal endeavored to bring these contra-
dictory views into harmony in his work entitled
" Respiration and Its Relation to the Vagus Nerve."
According to his opinion, some of the investigators
must have either been grossly deceived, or, what
was more probable, an important circumstance
must have been overlooked by all of them. From
his experiments, which were made with great care
and thoughtfulness, he came to the conclusion that
the latter must be the case, as these varying results
may be dependent upon the jumping over of the cur-
rent from the vagus to the superior laryngeal nerve,
and that the experiments made by the others were
faulty, as the two nerves were not properly isolated.
When he carefully isolated both nerves, he ob-
tained, upon irritation of the superior laryngeal,
retardation of the respiration, and, under great
irritation, an expiratory tetanus ; whilst, by exciting
the pulmonary branches of the par vagum, accelera-
tion of the respiration was obtained, and, with great
irritation, inspiratory tetanus. He summed up the re-
sults of his investigations in the following paragraph:
" Respiratory movements are excited by the irri-
tation of the blood upon the central organ of respira-
tion. The transition of this irritation to the respec-
tive nerves and muscles finds a resistance by which
the constant excitation is transformed into rhythmi-
cal action. This resistance is diminished under the
action of the nervus vagus, increased by the in-
fluence of the superior laryngeal."
The question of the relation of the pneumogastric
nerve to the respiratory act seemed with this to be
solved, and the contradictory views of the authors
upon this point to have found an explanation. Yet
Rosenthal even was compelled to acknowledge that
by slight irritation of the par vagum, expiration, and
not inspiration, resulted, and he could not abso-
lutely deny Traube's theory, that the electrical irri-
tation of the vagus sometimes, in consequence of
the painful sensation, acted inhibitory, and pro-
duced expiratory movements, unless he doubted
the sensitiveness of the vagus. Moreover, further ob-
servation proved that frequently expiration resulted
from irritation of the vagus, even in those cases where
it and the superior laryngeal were carefully isolated,
and no transmission of the electric current from one
to the other could be possible. The theory brought
forward by Burkart and Pfliiger, that the inferior
laryngeal nerve also supplied inhibitory fibres, did
not fully explain these contradictory theories ; but,
finally, the beautiful experiments of Breuer and
Hering brought new light upon the question.
They struck out in an entirely new path of inves-
tigation, and arrived at the conclusion that the peri-
pheral ramifications of the pulmonary branches of
the pneumogastric not only contain inspiratory
fibres, but also expiratory ones ; and the fact that
by irritation of the vagus the diaphragm may assume
either the position of inspiration or expiration, is,
therefore, no longer surprising.
Breuer opens his article, " The Self-Control of the
Respiration Through the Vagus," with the follow-
ing sentence :
" The expansion of the lungs acts reflexly inhibi-
tory to inspiration, but conducibly to expiration,
and the more forcibly the greater the expansion :
this action is conditional to the integrity of the par
vagum, and the fibres acting in this way upon the
medulla oblongata run in its course."
In order to convince myself of the accuracy of
this proposition, I made a series of experiments, all
of which led to the same results as given by Breuer.
The method and manner of performing the experi-
ments were as follows : A T-shaped tube was fas-
tened air-tight into the trachea of the animal to be
experimented upon, and to the arms of the tube
were fastened two leather pipes. The shorter pipe
was furnished with a side opening, through which
the animal breathed, and where, also, artificial res-
piration was produced ; the other one was attached
to the manometer of a kymographion. A glass
tube served for the manometer, which was fastened
air-tight at one end to the tube, and hermetically
sealed at the other with a thin elastic mem-
brane. To the rim of this was glued on, perpen-
dicularly to the axis of the tube, a slender rod,
which was provided with a pen for tracing the
curves. When the respiratory tube was closed, the
vibrations arising from the respiratory motions were
imparted to the elastic membrane, and thence to
the pen. During the experiment an electro-magnet
marked at the same time metronome time.
First Experiment. — A rabbit was made apnceic
by energetic artificial respiration, and then the
lungs were inflated, and the tube closed. The first
respiratory movement was not inspiratory, as one
might suppose from the communication with the air
being cut off, but an expiration.
Second Experiment. — The lungs of the same rab-
bit were inflated after it had been made dyspnceic,
by closure of the respiratory tube. Notwithstand-
ing the dyspnoea, no inspiration followed ; the first
motion was that of expiration.
The results here described occurred in great regu-
larity in a large number of experiments which I
have made, and it is well established that, with the
expansion of the lungs, there exists a hindrance to
inspiration and an incitation to expiration. With-
out entering into a further discussion to refute the
theoretical assertions that these appearances do not
arise from the expansion of the lungs, but from
other factors, as,, for example, a greater or less
abundance of oxygen in the blood, or circulatory
derangements, I will only cite as a proof that the
nerve fibres which, by inflation of the lung, act in-
hibitory to inspiration and promotive of expiration,
originate in the vagus, that whenever I divided it
the inflation of the lung produced no effect either
upon inspiration or expiration, and therefore veri-
fies the observations of Breuer and Hering.
The second proposition which Breuer and Hering
bring forward in their paper is that, " by diminu-
tion of the volume of the lung, every active expira-
tion will be momentarily assisted, and an inspiration
will immediately follow."
The following facts favor this view, which I have
found confirmed in every particular :
Upon opening the thorax of a rabbit, and produ-
cing a collapse of the lungs thereby, there imme-
diately appeared an inspiratory spasm of the nose,
which only passed off with the increasing dyspnoea.
If I performed artificial respiration, and continued
it until the animal lay quietly without breathing,
and then, by suction of the trachea, produced a sud-
den collapse of the lungs, in the majority of the
The Medical Union.
275
cases the apnoea was immediately arrested by an
energetic inspiration.
After having made the animal dyspnceic, and by
inflating the lung produced an expiration, I could
immediately increase the latter by exhausting the
air from the lungs, and then the labored expiration
was promptly followed by a deep inspiration.
Finally, I will also add that, after the division of
the vagus, suction upon the lungs had no influence
either upon inspiration or expiration. All the
experiments cited in this chapter demonstrate the
correctness of the theory of Breuer and Hering —
first, that changes in the volume of the lung,
either expansion or contraction, reflexly affect the
respiration ; and secondly, the filaments which pro-
duce the various reflex movements extend to the
ramifications of the pulmonary branches of the
pneumogastric. Consequently, the view of Rosen-
thal is refuted, that if expiratory fibres are only
found in the superior laryngeal nerve, the inspira-
tory ones exist in the contour of the lung, and the
discovery of Burkart, that expiratory fibres exist in
the inferior laryngeal nerve, receives further confir-
mation.
In making these experiments several things have
occurred which appeared so remarkable to me that I
have paid especial attention to them. Prof. Fick
has already observed, in repeating Breuer's experi-
ment, that when dyspnoea is produced, it is of
longer duration if the lungs are inflated than if
collapsed.
At Dr. Fick's suggestion I have made several
experiments with this in view, and, relying upon
them, will assert the following : Existing apnoea
is protracted by inflation of the lungs, but cut short in
the majority of cases by exhausting them ; or, at
least, it is greatly shortened.
The following experiments prove the justice ot
my assertion :
Experiment I. — The experiment was made upon
a rabbit, the preparations for which being made as
previously described. Artificial respiration was
energetically made for one and a-half minutes, and
the respiratory tube was closed. The animal lay
twelve minutes quietly without breathing. Then
artificial respiration was again performed, and the
lungs inflated previous to the closing of the tube.
Now, it was one minute and six seconds before the
animal commenced to breathe, and the first respira-
tory motion was an expiratory one. Once more
artificial respiration was performed, and the lungs ex-
hausted of air before the tube was closed. The animal
inspired immediately, and the dyspnoea ceased.
Experiment II. — Artificial respiration was also
produced for one and a-half minutes on a rabbit,
and then the lungs inflated — the apnoea lasted
fifty seconds. After the animal had breathed
quietly for some time, artificial respiration was
again performed for the same length of time, and
then the air sucked out of the lungs. Now, it was
only ten seconds before inspiration occurred.
Omitting all comment upon any theory depend-
ent upon these experiments, I will state another
observation which I made, together with the experi-
ments which led to it.
If the respiratory tube be closed without artificial
respiration having been previously performed, the
frequency of the respiration is notably less when the
lungs are previously in an inflated condition than
when collapsed.
In the experiments cited below, I have made one
minute as the measurement of time for the duration
of each experiment.
Experiment I. — With the lungs inflated, there
were fifteen respirations per minute ; with the lungs
exhausted, there were seventy respirations per
minute.
Experiment II. — With inflated lungs, there were
eight respirations per minute ; with exhausted lungs,
there were twenty-seven respirations per minute.
Experiment III. — With inflated lungs, there
were twelve respirations per minute ; with exhausted
lungs, there were thirty respirations per minute.
Experiment IV. — With inflated lungs, there
' were five respirations per minute ; with exhausted
lungs, there were eighteen respirations per minute.
The fact is unequivocally patent that the fre-
quency of the respiration, when the lung has been
exhausted of air, is notably greater than when in
an inflated condition under corresponding circum-
stances.
Upon the basis of these experiments, I believe
that I am able to corroborate the views of Rosen-
thal, Hering and Breuer upon the theory of the
respiration, and can complete them with an ap-
pendix, so that they may be expressed in entirety,
as follows : The respiratory movements are caused
by a continual irritation of the blood upon an in-
spiratory centre and an expiratory centre. The
transmission of this irritation is met with a resist-
ance, whereby the constant excitation is transformed
into rythmical action. This resistance is less for the
transition to the inspiratory centre tha7i to the expi-
ratory one.
The expansion of the lungs increases the resist-
ance for the inspiratory centre, and diminishes it
for the expiratory one j and the contraction of the
lungs increases it for the expiratory centre, and
lessens it for the inspiratory one.
Whilst the first of these propositions, viz. : that
the blood, by a constant irritation, acts upon the cen-
tral organ of respiration, is demonstrated by J.
Rosenthal, and the latter, that the changes in the
volume of the lung act either restrainingly or con-
ducibly to the transmission of the irritation by
Breuer and Hering ; it remains for me to prove that
the transmission of the irritation to the inspiratory
centre meets with less resistance than to the expira-
tory centre under similar circumstances. The ex-
periments cited above favor this view, and their
results may be recapitulated as follows :
First. On the disappearance of an apncea which
has been artificially produced, if the animal is left
quietly alone, the first respiratory movement which
the irritation upon the respiratory centres excites
is always that of inspiration and never of expiration.
Second. The proposition which I previously made
that apncea occurring when the lungs are exhaust-
ed of air is of shorter duration than when coincident
with their inflation, is explained only by the above
acceptation. By exhausting the air from the lungs,
the resistance, although small, which consists in
the transmission of the respiratory irritation to the
inspiratory centre, is made much less. When respi-
ratory irritation, which has been suspended during
the apncea, returns again, it is not necessary that
it should attain as high a degree as ordinarily to
be transmitted to the inspiratory centre, and there-
fore it consumes less time. If, on the contrary,
the lungs are inflated after the apncea has been
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The Medical Union.
produced, and the transmission of the respiratory
irritation to the inspiratory centre thereby cut off,
and only its transferrence to the expiratory centre
left possible, a longer time expires before it attains
a sufficient degree to excite a respiratory move-
ment, although its transition to the expiratory cen-
tre is now more easy — a proof that its transmission
to the expiratory centre, even under favorable
circumstances, meets with greater obstacles than
to the inspiratory centre. The longer duration of
the apncea when the lung is inflated, is thus easily
explainable.
Third. Finally, the proposition previously stated
that the frequency of the respiration is greater in a
lung which has been exhausted of air than in an
inflated one, argues for the lesser resistance which
the irritation of the blood upon the respiratory
organs meets in its transition to the inspiratory
centre, and can only be explained through such
an acceptation. If the air is exhausted from the
lungs, then the transition of the irritation to the
inspiratory centre is rendered more easy than it is
ordinarily, and the frequency of the respirations is
therefore more rapid as the resistance is diminished.
But if the lungs are inflated, and the easier way for
the transmission of the respiratory irritation to the
inspiratory centre cut off, a longer time must ex-
pire before the irritation has attained a sufficient
degree that it is able to overcome this greater re-
sistance offered by the only remaining way open to
the respiratory centre, viz. : by the way of the ex-
piratory centre. The frequency of the respiration
will be greatly diminished, as it requires, as in the
previous case, that the respiratory irritation be con-
served a longer time to excite a respiration.
The frequency first becomes more rapid again,
when through the increasing dyspnoea (as the com-
munication with the air is cut off) the irritation
itself obtains a greater force. I have, consequently,
always broken off my experiments before such a
dyspnoea occurred, in order that I might obtain, so
far as possible, clear and reliable results.
Accepting that the respiratory irritation meets
with lesser resistance in its transmission to the
inspiratory centre than to the expiratory centre, the
fact that with the inflated lung the apncea is of
longer duration, and the respiration less frequent,
is brought to harmonize with the assertion of Breuer,
that by inflation of the lung the nerve fibres are
excited which are inhibitory to inspiration and pro-
vocative to expiration. And, indeed, with this dis-
covery of Breuer, one would easily conclude to meet
with the results which I have obtained with refer-
ence to the duration of the apncea, and the fre-
quency of the respiration.
-Liquor Sod^e Chlorinatte (Labarraque's
Sol. ). — Dr. Robert T. Cooper, in the British Journal
of Homoeopathy, after giving several clinical cases in
which this drug was used, is convinced that the
lower portion of the spinal cord is greatly affected
by this compound of the Salts of Sodium. He
thinks it will prove of benefit in those spinal dis-
eases where the paroxysmal* sufferings manifest
themselves in the morning. In the enuresis somni
of children, four or five o'clock in the morning is a
very usual time for the bladder to become disturbed,
the wetting the bed usually occurring about that
time. Seminal emissions usually occur in the
morning, and the more violent paroxysms of
asthenia come on at that time ; and generally, all
these diseases are relieved by this drug. In one
striking instance, where seminal emissions had con- i
tinued for three years, and the .patient was reduced ^
to a painful state of physical and mental depres-
sion, but one emission occurred after commencing
with the Liquor Sodae, notwithstanding he had pre-
viously been under able medical care, and electric-
ity had been carefully used. He looks upon the
Liquor Sodae as the most efficacious remedial agent
in asthmatic affections he has ever used, and quotes
several cases where it has shown a remarkably
curative action. It is the tout ensemble of the drug,
and particularly its cerebro-spinal action that ren-
ders it so valuable in asthma. It is particularly use-
ful when we get a dilated condition of the right
side of the heart from venous obstruction, and its
attendant constriction of the chest and interscapular
pain in the presence of much bronchial expectora-
tion and hypogastric sinking.
He places the Liquor Sodae in juxtaposition with
Merc. Cor. and Arsenic, and believes it can produce
a condition of the intestinal mucous membrane re-
sembling that met with in dysenteric affections, and
mentions cases where it has relieved the thirst, tenes-
mus, and sympathetic pains, and materially assisted
the restoration of the recuperative powers in the
debility following diarrhoea and dysentery.
He thinks the drug loses its power by dilution,
and especially in uterine affections is absolutely
inert in the highly attenuated form. It often causes
exhaustion, accompanied by painful depression of
spirits ; but this effect is merely temporary. When,
however, it is followed by emaciation, it should at
once be discontinued. In destructive degeneration
of tissue, with increase of the albuminates and or-
ganic constituents in the urine, and general wasting
of the entire system from a non-disposition and
absorption of fatty material and consequent reduc-
tion of temperature, with enfeeblement of blood-
propelling power ; in chronic diseases, attended
with anaemia, especially in spinal affections where
ammoniacal decomposition of urine takes place, with
excessive secretion of mucus and phosphatic de-
posits, and when the contractile power of the blad-
der is lessened, the Liquor Sodas will materially
contribute towards convalescence by exhibiting a
striking influence upon the cerebro-spinal system of
nerves. It will thus arouse the pent-up energies of
pneumogastrics and phrenics, and will stimulate
the respiratory effort and exalt the vital capacity,
thus allowing a larger quantity of blood to become
aerated, and diminishing the strain put upon the
right side of the heart, and lessening any asthmatical
tendency, with the praecordial distress, and apicial
cardiac pain, and the interscapular neuralgia
In vitiated conditions of the system arising
from an insufficient supply of well oxygenated air,
or from the imbibition of poisonous emanations, or
from the constant use of water contaminated by
metallic or organic impurities, or from partaking of
unwholesome animal or vegetable food ; and in
forms of weakness favoring the generation of para-
sitic germs upon the skin and mucous membranes ;
or dyscrasias produced by the reabsorption of per-
spiration retained in the textures of the clothing ; j
in putrid dyspepsia ; or, in fact, in any affections ac- \
companied by putridity, this Chlorine compound
generally proves serviceable. ,
The Medical Union
277
The Medical Union
A MONTHLY JOURNAL
Of Medicine, Surgery, and the Collateral Sciences.
Editors :
EGBERT GUERNSEY, M.D. CHARLES E. BLUMENTHAL, M.D.LL.D.
JOHN C. MINOR, M.D. ALBERT E. SUMNER, M,D.
H. M. PAINE, M.D.
Published on the First of each Month, by
C. T. HURLBURT, 898 Broadway, New York.
NEW YORK, DECEMBER, 1873.
" A regular medical education furnishes the only prestimptive
evidence of professional abilities and acquirements, and ought to be
the only acknowledged right of an individual to the exercise and
honors of his profession." Code of Medical Ethics, Amer. Med.
Ass., Art. iv, Sec. i.
The publisher of The Medical Union, de-
sirous of commencing the new year with a greatly
increased subscription list, offers to all new sub-
scribers for 1874, the November and December
numbers of the present year. If those who approve
the course of the journal will endeavor to extend its
circulation among their professional brethren, they
will enable the editors to increase its attractions,
and render it still more worthy their support.
HERCULES' HELP.
The answer comes back now as of old : " The
gods never help those who do not help themselves."
If we would witness the triumph of our principles,
every heart must be engaged in the work, and every
mind earnest in its efforts to help on the great
cause, not for any selfish victory, but for the good
of humanity. There is no mind so barren, no life
in which there does not at times come opportunities
of thought and action which, if placed on record,
would serve a useful purpose in our great medical
temple ; a light, perhaps, through which some life
might be saved, or some human suffering relieved.
We may call as much as we choose upon our
political gods for legislative help ; unless that call is
enforced by earnest, practical work, by a united
strength, weakened by no selfish considerations,
it will be of no avail. In the medical world a school
is judged, to a very great extent, by the ability with
which its views are presented, by its literature, by
its record of scientific discoveries, and the monu-
ments of its earnest convictions and disinterested
work seen in its hospitals, dispensaries, and col-
leges. It is true that our school can point to many
works of signal ability, to a splendid array of facts
in the field of therapeutics, and to a few hospitals,
colleges, and dispensaries. And yet it is no less
true that our literature lacks strength, the strength
of earnest workers and careful observers bringing
to the common storehouse for the good of the
whole profession, the researches and facts gathered
in their daily work; the strength of great minds
discussing great principles from the stand-point of
enlightened science, and bringing to the aid of our
enlightened therapeutics, the wealth of scientific in-
vestigation in the great domains of nature. Even
in therapeutics the wheat is often, so mixed with
chaff, the pure gold so enveloped in baser alloys,
that the physician, despairing of getting at the
truth in the mountain of rubbish before him, some-
times throws down his Materia Medica, and falls
back on general principles. Oh ! for some master
mind to winnow out the truth, and gather into one
harmonious whole, the grand facts of our thera-
peutics. For much of the ridicule heaped upon us
by our opponents we are indebted to the crudities
and worse than nonsense which we see on almost
every page of our Materia Medica.
In dispensaries and hospitals we have lagged far
in the rear. The fault has been, in a great mea-
sure, our own. Nearly one-half of the taxes paid
in this city comes out of the pockets of those
who believe in our school of medicine, and yet, with
but very few exceptions, the hospitals . and dispen-
saries of this great city and the entire Sanitary
Board, with its immense patronage, are in the
hands of our opponents. In the great hospitals of
the city we have no place, and our voice is unheard
in the great works of charity. It is idle to suppose
that with well-directed and united effort — all minor
differences being forgotten, all petty spites obliter-
ated, all working for the triumph of great principles
and the good of humanity, with the splendid array
of wealth and talent and culture believing in those
principles and only awaiting some practicable plan to
give it their aid and full endorsement — we should
fail. We have let others found the hospitals and
asylums instead of taking the lead ourselves, and
then grumbled because we were not placed on the
medical staff. Within the past few years more than
one opportunity has occurred, where we might
have got a strong position in the great charities
of the city, with a little more liberality and skill in
our management. Our splendid insane asylum at
Middletown, which will, in a few days, be opened
for the reception of patients, is a proof of our asser-
tion. We went about this matter in a practical way.
We showed the absolute necessity of a new institu-
tion ; that our asylums were overcrowded ; and that
in every alms-house in the State were lying, almost
278
The Medical Union*
uncared for, and dying of neglect, men and
women whose only crime was that the light of
reason had gone out in their minds ; and that
with care and enlightened treatment they might
be saved. The State was not backward, when
the matter was properly presented, in doing all
that was needed. What has been done may be
done again, and the gates of our great charities,
trebly barred as they are with bigotry and intoler-
ance, yield to a few well-directed blows. It is not
necessary to march in with state, with banners fly-
ing and trumpets braying, like a conquering host
dictating terms to the vanquished, but quietly take
our place and hold on to it with the strongest of all
grasps, the grasp of work so well and skillfully
performed as to challenge the admiration even of
our opponents.
It is not always a pleasant task to criticise and
censure, but it is better that we ourselves should pull
the motes out of our own eyes, and look squarely
at the facts, rather than go on blindly, folding the
mantle of our own conceit and self-sufficiency closely
around us.
We need a broader and stronger literature ; books
which will discuss scientific questions with a breadth
and strength of intellect, and a wealth of informa-
tion and research which will command respect ; a
periodical literature not afraid to grapple with the
questions of the day, and keep fully up to the prog-
ress of the times; a foothold in the great charities
of the State and nation. It is not because we have
not within our ranks men capable of great work,
but because too many of them hide their talents in
the circle of their daily practice, and forget that no
man has a right to hide from the world facts which
benefit the race. Come out from your quiet nooks,
oh. ye laggards ! and let your voices be heard, and
your strength felt, in the grand battle for truth and
progress.
BROOKLYN HOMEOPATHIC MATERNITY.
From the third annual report of this institution
we make the following eloquent extract from the
statement of its corresponding secretary, Mrs. L. A.
P. New:
" To aid the friendless; to save the fallen; to lov-
ingly care for the little ones left floating on Life's
tide, subject to all its tossings and adverse currents ;
to train women, brave and strong, tender and true,
to go into our homes and minister at our bedsides
with intelligent care and thoughtfulness — this is the
work of a ' Maternity,' and this, with God's help,
we are trying to do*
" The year just past will be ever memorable in the
history of our loved charity. It opened during days
of great trial, when it required much courage, and
a firm conviction of the purity and uprightness of
all our intentions, to sustain us.
"As the clouds which had darkened our pathway
grew thinner, and our hearts proportionally light,
our thoughts turned again to some of our original
plans, which were to cover in time a much larger
field of usefulness, in the way of mother work, than
we had been doing. Want of room had been our
hindrance heretofore, but we finally decided to or-
ganize the departments; and if our hive should
prove too small, to swarm, as soon as a larger one
could be obtained for our purpose.
"In this we were ably seconded by Dr. Sumner,
our Medical Director. In truth, he has been our
captain, leading us when our hearts were too faint
to see the way alone.
" A Nursery, a Child's Hospital, and a School for
Training Nurses, were organized; the latter being
deemed of sufficient importance to require a special
charter from the State.
" Having added so many departments to our orig-
inal institution, it became necessary to assume a title
which should comprehend the entire work we pro-
posed to do, and the name of the ' Brooklyn Ho-
moeopathic Maternity ' was unanimously adopted ;
this title to be accompanied with the names of its
four divisions ; and on the 7th of June the Maternity
gave its first formal Reception.
"A pleasant crowd gathered in our rooms ; much
interest was evinced, and the generous subscription
of nearly six thousand dollars toward our building
fund was left behind as a tangible proof of their
kindly feeling toward us.
" During the past year there have been sixty -nine
women admitted to the lying-in wards, sixty-Jive
births, and no deaths of our own patients; the
only death being that of poor Ann Dunsworth,
whose sad end was made the theme of so much
mistaken discussion through the public journals.
She was a child, barely fifteen years old, whose
youthful ignorance led to her own betrayal, and who
had been left in the street in the hour of her ex-
tremity, to be picked up as might be or die. A
kind-hearted policeman brought her to our door,
and the poor, chilled, benumbed and suffering girl
was taken in and cared for as tenderly as if she had
been surrounded by loving friends. It was evident to
our physicians that she was suffering from something
more than labor, but, until delivered, it was im-
possible to say what ; no sooner, however, was her
child born, than the symptoms of typhoid fever in
an advanced stage developed rapidly, and termi-
nated fatally the next day. It was ascertained that
there were cases of typhoid fever of a malignant
type in the house where she had been staying, and
she had there contracted the disease, which was
The Medical Union.
279
greatly aggravated by the neglect and exposure fol-
lowing.
" We have had but two cases of still-birth, and two
have been born with a malformation of the heart,
which resulted speedily in death. We have fur-
nished seventeen wet-nurses, besides those employed
in our own nursery. Four girls led astray under
promise of marriage have been saved from a life of
shame by being honorably married to their seducers.
Seventeen poor women, who have been deserted or
neglected by drunken and dissolute husbands, have
been cared for, and helped to good situations when
discharged.
' ' We have given temporary aid and shelter to a
large number of women with young babes, who
came to us in despair, having been refused admit-
tance to other institutions.
" The Nursery was opened for the admission of
patients on the 15th of March, 1873. Since then
fifty-six children have been admitted ; thirty-two
discharged; ten have been adopted, and seven have
died ; there are sixteen now in the Nursery.
" The School for Nurses has been in the course of
preparation during the summer, under the supervi-
sion of Mrs. H. W. Sage (chairman of that commit-
tee) and of the medical staff.
"Rooms have been fitted up in a most comfortable
manner for the occupation of pupils ; arrangements
made for courses of lectures, for procuring models,
manikins, books, &c, and the school was formally
opened on the 7th of October, Dr. Sumner de-
livering the opening address.
" Great pains have been taken to make this branch
of our. work thorough and popular. The need of
skilled and trained nurses, educated women, who
can be companions as well as nurses ; who shall do
their work in an intelligent manner, understanding
all the complications that may arise in a sick-room,
and how to meet them ; having a clear knowledge
of all that pertains to hygiene, and its relations to
health, and to the use of medicine, is a need known
and felt by all. It is our purpose to send out young
and active women who shall be perfectly fitted for
this profession in every particular. The course of
lectures connected with the school will be exception-
ally valuable to wives and mothers, and we propose
to admit any such who may desire to avail them-
selves of such a course, by the payment of a certain
sum which will be fixed upon by the committee.
" On the 1st of May next we shall come into the
possession of the building adjoining (which is ours
now, by purchase) ; our wards will then be doubled
in size, and our arrangements in every way more
complete. We shall also be able to offer private
rooms for people of means who wish to avail them-
selves of our superior facilities for hospital confine-
ment treatment.
" Our medical staff have rendered prompt and
cheerful aid; every mother and every child in the
Nursery have received as minute and careful atten-
tion as though they were private patients."
The following report of the Medical Director, Dr.
A. E. Sumner, still further illustrates the work of
the Maternity :
" One year ago we were without a permanent
home, and without means of subsistence, and there
were some among us who doubted our ability to live
through another year. The year has been an event-
ful one for us. We are now safely settled in our
own home, and while many changes are necessary
to make it complete, still it answers every purpose
for the present. New friends have sprung up on
every side, and the means have been provided for a
work increased fourfold. New departments have
been established from time to time, until we find
ourselves with a Lying-in Hospital, a Nursery, a
Child's Hospital, and a School for Training Nurses.
Each one of these departments, with the exception
of the first, has been established during the past
year, and they are all in good working order. The
first department is in perfect condition. During the
year we have received sixty-nine patients, and sixty-
five have been confined without loss of life. The
remainder are at present in the house. Two infants
were still-born, and two were born with malformation
of the heart, and died soon after birth.
"The Nursery was established on the 15th of
March, and has already received fifty-six children.
Of this number only sixteen remain. Seven have
died, ten have been adopted, and thirty-two have
been discharged. The statistics of this department
are, so far as I know, unparalleled. The great de-
gree of care required by infants in the selection and
preparation of food, renders the Nursery the most
difficult department of all to conduct successfully.
The infants are all under one year of age, and are
left by the mothers in order that they may obtain
situations as wet-nurses. The change of diet is al-
ways felt by the child, and in many cases sickness is
the result.
" The Children's Hospital has not yet received the
attention that it deserves, but it has been neglected
only for want of means. '
" The School for Training Nurses is now in suc-
cessful operation. It was formally opened on the
7th of October, and the lectures and clinics are being
regularly held in the Maternity parlors. I believe
that this feature of our work is of great importance,
and I also believe that this school is destined to play
a very important part in the history of our institu-
tion. Manikins, casts, text-books, charts, &c,
have been provided, in order that the course should
280
The Medical Union.
be rendered entirely practical, and the result is sure
to be creditable. As a whole, our work has been a
complete success, and the foundation i's laid for a
noble charity that shall outlive us all."
Brooklyn now has, under Homoeopathic care, a
t
well-appointed Nursery, a report of Avhich we gave
in a recent number of the Union; a Dispensary
treating several thousand patients a year, and, with-
out exception, the most complete in all its depart-
ments of any dispensary in the world. Besides,
three other dispensaries, with a large clientage, an
elegant Hospital in good working order, a Nursery,
Lying-in Asylum, Child's Hospital, and School for
Nurses, under the same roof.
All of the institutions are managed with an ener-
gy, liberality, success, and broad and Christian
spirit, of which our school may well be proud.
Brooklyn has set an example in the successful ac-
complishment of well organized plans in her works
of charity, which other cities might do well to im-
itate. These institutions are not only doing an im-
mense amount of good to the poor, but furnish, by
the abundance and variety of material, a practical
school for clinical teaching of vast importance to the
rising profession.
itorre$pon6ence*
PUBLICATION OF THE TRANSACTIONS OF THE
STATE HOMEOPATHIC MEDICAL SOCIETY.
There is published in a recent number of the
Medical Record a short editorial, commenting on
the refusal of the last Legislature of this State to
publish the Transactions of the Allopathic Medical
Society, and expressing the opinion that " it would
be a blessing in disguise, in that it would stimulate
the members to action in their own behalf."
The November number of the Buffalo Medical
and Surgical Journal. contains an editorial of simi-
lar import, and "hopes that steps will be taken
soon to place the State Allopathic Medical Society
upon a basis entirely independent of State control."
A series of resolutions has been adopted by the
New York County Allopathic Medical Society and
the Monroe County Allopathic Medical Society,
pledging these respective societies to pay the pro-
portional expense of the publication of the transac-
tions of the State Allopathic Medical Society.
The resolutions do not express the views of the
parties who adopted them, regarding the import-
ance or desirableness of securing the publication of
the several medical reports by the State ; neither
are they expressive of the least gratitude for the
favor hitherto extended to the medical societies ;
neither do they solicit a continuance of this form
of State assistance. On the contrary, they are
expressive of a determination to rely on their own
unaided efforts, believing that the trial will prove a
"blessing in disguise:" that a condition of " inde- \
pendence of State control " is very desirable.
The movers " advise the State Society to become
entirely independent of State patronage," and an-
ticipate that as the society is now alone responsible
for the publication of its transactions, the members
will take pride in making them a model publication.
These statements imply that while the allopathic
profession may have considered the publication of
their annual volume of transactions for nearly
twenty-five years by the State to have been very
important, they do not now desire its continuance ;
in fact, they exhibit a decided feeling of relief from
any connection whatever with State interference or
patronage.
The influences which have been contributing to
produce this anomalous position of the allopathic
school are traceable, without doubt, to the spirit of
rivalry which exists between the adherents of the
two principal systems of medical practice. It is
simply a new phase of opposition to homoeopathy.
By refusing the publication of their own report by
the State, they hope to prevent the continued pub-
lication of the report of the Homoeopathic State
Medical Society.
The position assumed by the homoeopathic school
is a very different one. We desire to state dis-
tinctly, that the annual volume as heretofore pub-
lished by the Legislature is far more valuable and
useful to the members of our profession than any
we could publish independently of State aid.
That we gratefully appreciate the favor hereto-
fore extended to the homoeopathic profession in this
State, in the annual publication of its transactions.
That, as a class, physicians devote their whole
lives to the development of means for the relief of
human suffering ; and that whatever contributes to
the promotion of harmony and mutual improvement
in all the departments of medical science is of di-
rect benefit to the people.
Having not only the welfare of the people of this
State in view, as well as the benefits that will un-
doubtedly accrue to the members of our profession,
by stimulating more thorough organization and
more frequent and more widely extended compari-
son of mutual experiences, we earnestly desire the
members of the Legislature to continue to extend
to the homoeopathic profession in this State the
same evidence of its interest and fostering care that
it has done during the past ten years.
It is very desirable that the several county homoeo-
pathic medical societies in this State should con-
vene at as early a period as practicable, and give de-
cided expression of their views regarding this import-
ant subject.
On the 13th of May (1873) last, the following res-
olutions were adopted by the Albany County
Homoeopathic Medical Society:
Whereas, The annual publication of the transac-
tions of the State Medical Societies, for many years
past, has greatly contributed to the advancement
of medical science and development of well reg-
ulated medical organizations throughout this State,
thereby elevating the standard of the medical pro- m
fession, and through it directly promoting the wel-
fare of the people ; and
The Medical Union.
281
Whereas, Other States, in imitation of its exam-
ple, are wisely and liberally publishing similar re-
ports, and also by other measures fostering and di-
rectly or indirectly supporting their own medical or-
ganizations; and
Whereas, The publication of the medical reports
by the Legislature of this State constitutes the only
form of pecuniary aid at present extended to the
medical profession; therefore,
Resolved, That we gratefully appreciate the valua-
ble and important assistance hitherto extended in
our behalf, and respectfully request that a plan may
be matured by the Legislature now in session for
securing the publication of the usual number of
medical reports.
The Rensselaer County Homoeopathic Medical
Society adopted the following resolution, October
28th, 1873:
Whereas, The publication of the transactions of
the State Homoeopathic Medical Society for several
years past has contributed to the elevation of the
standard of Medical Education and advancement of
medical science, and the efficiency, harmony and
thorough organization of the medical profession, and
thereby directly promoted the welfare of the people ;
and
Whereas, At the last session of the Legislature, on
alleged economical grounds, as we believe unwisely,
the publication of said report for the current year
was suspended ; and
Whereas, In our opinion the interests of the
members of the medical profession and of the peo-
ple of this State will be promoted by the continued
publication of the usual number of copies of said re-
ports ; therefore,
Resolved, That we respectfully request the mem-
bers of the Legislature from this county to exert
their influence in favor of the publication of the trans-
actions of the State Homoeopathic Medical Society.
It is to be hoped that resolutions of similar im-
port will be adopted by each of the county homoeo-
pathic medical societies in this State.
A Ibany.
H. M. Paine, M. D.
^Transactions of Societies,
NEW YORK COUNTY HOMCEOPATHIC MEDICAL
SOCIETY.
The annual meeting of the New York County
Homoeopathic Medical Society was held at the
Ophthalmic Hospital, Wednesday evening, Decem-
ber 10. The meeting was devoted to the hearing
of the reports of the Treasurer and Secretary, and
the election of officers. The following were ap-
pointed for the ensuing year : President, Dr. Hel-
MUTH; Vice-President, Dr. THROOP; Secretary,
Dr. Hills ; Librarian, Dr. Norton ; Censors,
Drs. Minor, Allen, Thompson, Linsley, Berg-
HAUS. Dr. Minor being unanimously elected,
was appointed the chairman of this board. The
following were elected honorary members of the
society: Dr. Johann Kafka, Prague, Austria;
Dr. Richard Hughes, Brighton, England; Dr.
\ Chas. Hemphill, of St. Petersburg; and Dr.
Leon Hermanns, of Paris. The following were
elected to fill vacancies of delegates to the State
Society: Drs. Doughty, W. N. Guernsey, T.
D. Bradford and Emma Scott. Drs. Minor
and Houghton were unanimously recommended
to the State Society for appointment as permanent
members to their body.
Reuieujs of Boohs.
The Homceopathic Physician's Visiting List.
By Robert Faulkner, M. D.,with a Repertory
by W. James Blakely, M. D. New York:
Boericke & Tafel, 145 Grand Street.
The general arrangement of this Visiting List is
excellent. It contains an obstetric calendar admir-
ably arranged; a list of poisons and their antidotes;
Marshall Hall's ready method in asphyxia ; tables of
the pulse ; and a very excellent repertory of the
leading remedies and their prominent characteris-
tics in the various diseases a physician would be
most likely to meet in his every-day rounds. Fol-
lowing, we have the usual vaccination, death and
obstetric record, and a page for daily engagements
and prescriptions for each week in the year. The
visiting list contains room for forty names a week.
To physicians of large practice the work would have
been much more acceptable if the visiting list con-
tained space for eighty names a week instead of
forty.
The Application of the Principles and Prac-
tice of Homceopathy to Obstetrics and
the Diseases Peculiar to Women and
Children. By Henry N. Guernsey, M. D.,
Professor of Materia Medica in the Hahneman
Medical College, Philadelphia. Second edition,
revised and enlarged. Boericke & Tafel,
Publishers, New York, 145 Grand Street ; Phila-
delphia, 635 Arch Street.
The appearance of this work as it lies open upon
our table strongly prepossesses us in its favor. The
tinted paper, the clean pages, the open type, and
the substantial binding, tell us, that whatever fault
we may find with the matter, the publishers have
taxed their resources in giving us one of the most
elegant specimens of book-making we have ever
seen issued from the medical press. In the early
years of our school we were too much engaged in
studying our materia medica, in adding to its wealth
by new provings, and in applying the information thus
obtained to the cure of disease in accordance with
our new therapeutic law, to have much time to de-
vote to the preparation of works treating more
particularly of pathology, physiology and the me-
chanical part of our art. But as years have rolled
on, and the principles of our school have become
more thoroughly established, a necessity has been
felt for text-books in the various departments of
medicine and surgery, in which its more natural
and scientific philosophy could be incorporated, not
only as a guide to students but as a help to the busy
practitioner in his daily work.
In the department of obstetrics, the author has
earned the right to speak with authority by long
years of careful study and the rich experience
gained by the bedside. While, in his teaching in
the lecture room, he has of course availed himself
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of the researches of others, gathering together
well established facts and authenticated principles
from every source, he has presented them in such
clear and elegant language, so enriched with his
own careful observations and original thoughts, that
we have not only a medical work fully up, in every
department, with the advanced state of the science,
but presented in a style so scholarly as to invest it
with a peculiar charm.
In the chapter on the anatomy and physiology
of the reproductive organs, while all important
facts are given in a clear and concise manner, much
of the minutia, which more decidedly belong to a
work on anatomy, are very wisely omitted.
In the chapter on reproduction, he thus elo-
quently describes what he considers the initial step
in the dawning life of the new being: "The semen,
viewed according to its chemical qualities, has no
power to effect fecundation and the primitive or-
ganization of a distinct and vitalized being. It is
upon the vital essence or spirit of the semen that its
power to impart life depends. The gross liquor
carries with it a part of the essential life of its giver,
which, meeting a similar vital essence of the female
organism in the ovum of the ovary, the conjunction
of these two vital essences is the process of fecun-
dation by and through which a new being results,
which partakes of the life of the man and the wo-
man, and which is in that instant made a living soul.
" The three constituent elements of the semen
correspond to the body, soul and spirit. Within
the inmost of each seminal nucleus is contained the
very highest soul and life of the parent ; the deli-
cate fluids which immediately surround it are in-
spired by the animal spirits, while the more gross
and external mucous developments correspond to
the animal body.
" This organization of the seminal globule which
makes it correspond to a representation of the
body, soul and spirit of the parent, finds in the
female ova a corresponding three-fold organization
equally representative of the female constitution.
The semen of the male, therefore, unites and com-
bines with the ovum of the female, in each one
of these three constituent and representative forms
in more or less perfect harmony, according to the
more or less perfect adaptability of the male parent
to the female. As in the mingling of different
races the stronger takes the lead and predominates
in the offspring, so in the union of the seed of the
different individuals, the stronger predominates in
the moral, mental and physical characteristics im-
pressed upon the child. Thus, as the lower, more
gross and material portion of the male semen meets
its counterpart in the. grosser organization of the
ovum with which it unites and which it vitalizes
with its degree of life, so each of the other constit-
uent forms of the semen necessarily unite with and
inspire the corresponding representative organiza-
tion of the ovum. The ovum that receives, cher-
ishes and nourishes the vitality imparted to it by the
male semen, and the living form which is the result
of such reception, partakes of the qualities of the
ovum on the one part and of the semen on the
other, even as these are but faithful representations
of the various qualities, whether orderly or disor-
derly, of the male and female individuals from which
they spring."
After all, this is merely speculation. No hu-
man mind has ever yet, or probably ever will,
fathom the mysteries of life or remove the veil
which hides from human sight the steps through
which it is evolved. Still, the philosophy of the
New Church, which has evidently inspired the
above sentiment, is perhaps more satisfactory than
any other.
The chapters on the signs of pregnancy and the
development of the ovum and the foetus, contain
the most advanced teaching upon these subjects.
The author believes that the presentations depend
to a very great extent upon the health of the mother
during pregnancy, and that the abnormal presenta-
tions are almost always the result of ill health
during the period of carrying the child. The mech-
anism of labor is clearly set forth, but we should
have been glad if the author had devoted more
space to diagnosing the position of the child by ex-
ternal manipulation. This is so carefully done by
many of our best obstetricians that not only can
the exact presentation of the child be almost un-
erringly determined by external manipulations, but
even its position changed from abnormal to normal.
In the care of the child during labor, the author
believes that Nature is quite competent in most cases
of doing her work with but little of our assistance.
After the delivery of the head, he thinks that no
interference should be attempted, unless the child
seems in danger of strangulation or apoplexy, but
we are to wait for the delivery of the child by the
natural contraction of the womb ; and in breech pres-
entation, he recommends the same care, unless the
pulseless cord should prompt us to the speedy de-
livery of the child to save its life. In breech pres-
entation it has been our custom to deliver the child
as speedily as possible, taking care, however, to do
it cautiously, so as not to injure either the mother
or child ; and in head presentations, after the de-
livery of the head, we have never yet seen any
harm result from a little assistance in the prompt
delivery of the body. As much as we deplore the
useless intermeddling of bungling attendants, we
think the mother more frequently suffers because
too little is done rather than too much.
The author strongly objects to the use of the
bandage after delivery, and in this he agrees with
the Vienna school and many of our best obstetri-
cians. We never insist upon its use where the
mother objects, but we find in the majority of cases
it adds materially to her comfort. We always apply
it well down over the hips and extending up over
the abdomen to the stomach, pinned just tight
enough to give a feeling of support to the mother.
We have never found any injurious effect from
gently opening the bowels on the fourth day. At
this time, after the milk fever is over, we allow
them a well-selected and nutritious diet. Even
from the first, in case the patient is exhausted either
from loss of blood or any other cause, broths
and even wine should be given to increase her
strength. The author's description of the causes
and treatment of the various forms of difficult
labor is excellent, and his instructions as regards
the use of instruments in delivery, are all that
could be desired. He has also given a very clear
description of the disorders incident to pregnancy,
and suggested most of the important means of re-
lief. In the troubles which sometimes follow labor,
including puerperal convulsions and puerperal
fever, the author shows a wide range of information
and careful observation at the sick bed. He con-
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283
eludes his work, and makes it more complete, by a
careful discussion of the diseases of females and
children. If we have any fault to find with this
part, it is the tendency, as it seems to us, of relying
too much on the medication of drugs, and too little
upon dietetics and the well-established rules of
hygiene. But this fault, if it is a fault, every prac-
titioner will be able to correct for himself.
The work is a treasury of information, and will
form an almost indispensable addition to every
physician's library.
Taking Cold: Its Nature, Cause, Prevention
and Cure, Etc. By John W. Hayward, M. D.,
M.R.C.S., L.S.A. Fourth edition, enlarged and
improved. London : Henry Turner & Co.
This excellent little book is one of the best for
household reference we have ever seen. It is just
such a book as should find a place in every family.
Expressed in plain language, singularly free from
technical obscurities, its explanations are clear and
logical, and the advice as regards treatment is prac-
tical and judicious. Dr. Hayward has evidently
written this book so that it shall be available for
popular use; but the task has been so well done
that it would be a valuable addition to the library
of the physician as well. There are, unfortunately,
many larger and more pretensious works, written
by the authors in our school, that cannot bear any
comparison, as to intrinsic worth, with this little
treatise, whose fourth edition bears a practical tes-
timony to the estimation in which it is held.
A System of Surgery. By Wm. Tod Helmuth,
M. D., Professor of Surgery in the New York
Homoeopathic Medical College. Carle & Gre-
ner, Publishers.
The past few years have been prolific in Surgical
works. The magnificent " System of Surgery," edit-
ed by Holmes, far surpassed any previous work on
general surgery. Billroth's splendid treatise on
surgical pathology was rapidly followed by the
works of Spence, Gant, Bryant, Hamilton and
others; while in surgical monographs the profes-
sional literature has been enriched by the contri-
butions of Spencer, Wells, Atlee, Peaslee, Markoe,
and others, whose names are familiar to all. In
addition to these, many of the standard works,
such as Erichsen's and Druitt's, have lately been
revised, enlarged, and brought fully up to the re-
quirements of modern surgery. The French sur-
geons especially have made many valuable contri-
butions to surgical literature; and, in point of schol-
arly research and professional ability, the names of
Gaujot, Spillmann, Legouest, Gosselin, Sedillot,
Guyon, Broca, and Guersant, are among the most
eminent of surgical authors. In this field, so richly
stocked with the best works of the ablest living
surgeons, a new-comer must needs have some un-
usual qualifications or a vast experience to entitle
him to the attention of the profession; and a new
work on surgery must stand or fall on its merits as
compared with those that have already been ap-
proved.
Dr. Helmuth has for years occupied a prominent
position in our school as a teacher of surgery, and
may be said to represent us in that department.
His work is therefore not merely a personal affair,
but one in which we all have a certain amount of
interest, inasmuch as it represents not only the
author's knowledge and experience, but also the
kind of knowledge that is imparted to our students
and endorsed by our school. Perhaps our expec-
tations with reference to this work have been too
exalted, but we certainly looked for a better book
than this.
A patient examination of Dr. Helmuth's work
convinces us that the author has done himself an
injustice in issuing a book that contains every evi-
dence of haste and carelessness. The work has
some features that we shall praise, for we are not
disposed to allow its faults to prejudice us against the
good that we find ; but we cannot give a critical
opinion in this case without discriminating between
what is positively good and what is positively bad.
We should be unwilling to do any injustice to the
author or to the profession, and we should be
culpable in both respects were we to recommend
this work without a considerable reservation.
Were we permitted to give a critical estimate of
the value of the book as a whole by pronouncing an
opinion upon a portion of it, we should select the
author's treatment of the operative parts of surgery,
and certainly render a favorable decision, for here
our author shows himself a good surgeon in spite of
his book. And yet there is no account given of the
application of pneumatic aspiration to the diagnosis
and cure of disease. Fibrous anchylosis of the lower
jaw is considered without any mention of the only
operation that promises a permanent relief; we re-
fer to Esmarch's operation for the production of a
false joint. Amputation of the tongue is spoken of,
and a case of congenital hypertrophy is detailed in
which the author operated successfully with ecra-
seur; but we look in vain for any reference to Gur-
don Buck's operation by double flaps, a most in-
genious and admirable method. These and other
omissions will disappoint those who hoped for uni-
form excellence in the operative part of the work.
Fractures and dislocations are admirably consid-
ered ; the descriptions are concise and accurate, and
the treatment advised is invariably judicious. The
chapter on hemorrhage is also an excellent one, full
of practical suggestions and valuable informa-
tion. In general the operative procedures are very
clearly described and represent the most approved
methods.
We wish that equal industry had been exerted in
bringing the portions pertaining to surgical pathol-
ogy to a presentable degree of excellence. It is to
be regretted that obsolete theories have been so
tenaciously retained that not the slightest mention
or use has been made of the discoveries of Von
Recklinghausen, Cohnheim, Strieker and others of
the more advanced pathologists. When our author,
describing pus, tells us that " the corpuscles are
generally spherical," it would have been prudent to
have qualified this statement, since Von Reckling-
hausen has shown that only dead pus cells have this
round shape. And, again, we learn for the first
time of an " extra vascular " pus globule (page 1 18)
which will probably be new to those who have
never before known that a pus globule possessed
even the slightest degree of vascularity. In des-
cribing the dissecting aneurism, we are told that
" in this instance, the inner coat may remain entire,
or both the inner and external tunics preserve their
continuity." We must confess our ignorance of the
284
The Medical Union..
method by which a dissecting aneurism may occur
without a lesion of the inner coat.
We doubt whether our author shows to advan-
tage in the practical application of pathology when
he fails to enumerate the obliteration of varicose
veins as a possible method of curing varicose ulcers.
On some of the most profound questions of surgi-
cal pathology the author has not a word to say, or
else disposes of the subject with a few remarks,
which fail to answer the most reasonable expecta-
tion ; and so prominent is this defect that we are
unable to find in the whole book a single subject in
pathology treated with a full appreciation of its
importance, and of the researches and discoveries of
modern science.
The chief value of the book lies in the therapeu-
tical suggestions, and in its being a compendium of
surgical operations. It is lacking, however, in any
critical estimate of the comparative value of the
various operative methods, and does not, therefore,
meet the requirements of those who would consult
it for advice as to the best methods to be adopted
in individual cases. The work contains the pictures
and description of a vast number of surgical instru-
ments, and is printed with very clear type.
It will probably meet with a ready sale, on ac-
count of the general estimation in which the author
is held ; but we doubt whether it will be accepted
as a standard authority even by those whose surgi-
cal education has been acquired under his instruc-
tion. As a compendium of surgical operations and
instruments the work merits a high degree of praise
which cannot be awarded to it as "A System of
Surgery."
Mental Hygiene. By D. A. Gorton, M. D.
Philadelphia, J. B. Lippincott & Co., 1873.
This subject is eminently proper for a physician to
discuss. Viewed from the stand-point of his pro-
fession, it is looked upon from the practical side
rather than the theoretical. The theologian is too
apt to bring to its consideration the peculiar views
of his religious creed, which sometimes blind his
eyes to the real power and nature of facts as they
present themselves.
With the physician this subject forms part of his
daily life. Facts present themselves at every turn ;
and every hour of the day he is called upon to study
the relation between mind and matter. Scarcely a
day passes but what he meets evidence that the mal-
adies of the mind and the body may supplement
and counteract each other. He sees in almost
every form of disease the influences which one ex-
erts upon the other. What is mind ? where does it
hold its mysterious court, and how does it act upon
the matter which composes its material investment ?
are questions which the metaphysicians of all na-
tions and all ages, from Plato to Spencer, have dis-
cussed, and over which the chemist and physiolo-
gist, with crucible and knife, have pondered long and
earnestly, but have pondered in vain. The mechan-
ism by which mind transmits its mandates, through
which the soul speaks, has been laid bare, but the
secret spring, the spiritus vit<zr which sets the won-
drous mechanism in motion, no man has seen or
has yet been able to comprehend. We do know,
however, from the careful observations of physiolo-
gists, that the brain is indispensable to thought, to
feeling and volition, and that here in its billions of
starry cells, each with its nerve filament connecting
it with the great whole, each supplied with its ap-
propriate nutrition from the great current of blood
which sweeps a river of life through every part of
the body, itself fed from the great fountain, the
stomach, are formed those thoughts which make
mind victorious over matter, which elevate man
above the brute and link him with God.
The soul, the spiritual part of our organization,
has woven for itself an investment from the material
world, attracting to itself those elements necessary,
and arranging them in such a way as to enable it to
perform its mission in this world. This material
form is so interlaced and so interwoven with the
spiritual, their life so united and made one, that a
derangement of the material portion of the body
affects the spiritual or mental. Mental activity de-
pends upon the amount and quality of blood sup-
plied to the brain. For the brain to perform its
functions correctly, it must be furnished with the
right kind of nutrition, and in the proper quantity.
Failing in this, the brain starves, or its action is per-
verted by unhealthy food and unnatural stimulants.
Society, then, is directly responsible for very much
of the crime which exists in its midst, by neglecting
to remedy those evils which lead to crime. What
legislation can we expect when the brain is whipped
into unnatural action or the clearness of thought
benumbed by alcoholic or narcotic stimulants ? That
the maladies of any portion of the body- are tele-
graphed directly to the brain we have ample proof
every day of our lives. An attack of gout or rheu-
matism produces intense nervous irritability of no
very amiable kind. Gout is often attended by
great melancholy and depression of spirits, and
almost every form of disease produces its peculiar
effect upon the mind. Athanasians insist that
the harsh features of the Calvinistic theology are
simply the result of an aggravated form of dyspep-
sia in John Calvin, who, with a worn-out stom-
ach, retired from Paris to Geneva, and carried
out a system of theology which partook of the
gloom of his own diseased system. The Calvinist
retorts by telling the Methodist that the hopeful
spirit of his theology is tinged with the pulmonary
trouble of Wesley. Perhaps both are, to a certain
extent, correct.
In our early professional career we attended re-
ligious services at a Presbyterian church, where the
generally amiable clergyman would occasionally
fire off a sermon, bristling with the spirit of denun-
ciation and wrath. You could almost smell the
sulphur from the pit, and see the blue fire dancing
about the house. Called upon to attend him pro-
fessionally, we found he was a martyr to dyspepsia,
and that an aggravated attack was always followed
by what his people called one of his hell-fire ser-
mons. One of these sermons was always the signal
for us to send him a dose of Nux-vom., properly
labeled, very much to the delight of his family, who
were in the secret. At another time, we found one
of our most eloquent and earnest divines hard at
work late Saturday night, with a pot of strong tea
before him, which he said he always used when hard
pressed. He invited us to take a seat in his pew
the next afternoon, and hear his discourse. It was
really eloquent, and towards the close, where, in
preparing it, the tea had evidently been exhausted,
and he was fully under its effect, both himself and
congregation were moved to tears.
The Medical Union.
285
Defective nutrition and bad air produce a differ-
ent effect upon the educated and the ignorant.
The mental training of the one, the discipline of his
mind, may enable him to control, to a certain ex-
tent, the tendency to evil; while the uncultured,
without mental discipline, is too apt to rush head-
long into crime. That crime is far more prevalent
among the uneducated we have abundant statistics
to show. In France and Belgium in one year, sixty-
one per cent, of all accused of crime could neither
read nor write ; twenty-seven per cent, could read
and write imperfectly; ten per cent, could read and
write well, and only two per cent, had received a
superior education. The records of the insane asy-
lums show also that their walls are filled more from
the ranks of the uneducated and the poor than from
the educated. Mental labor does not of itself pro-
duce insanity ; on the contrary, the brain does not
wear out by even severe mental exertion, when the
system is kept in proper condition by the right kind
of food, and allowed sufficient rest. There is to-day
in France no more logical and far-seeing intellect,
and no safer guide than Thiers, now over eighty
years of age. Palmerston, even in old age, was
one of the most brilliant intellects in England.
Humboldt retained the fullness of his intellect until
his death, at .ninety. Franklin died at eighty-four,
in the full strength of his massive intellect. Hahne-
man died at eighty-eight, with his mind clear and
strong to the last. John Quincy Adams, "the old
man eloquent," fell at his post, strong in mind to
the last. And thus, as we turn over page after
page of history, we find the hardest thinkers, the
most energetic laborers in science, literature, and
art, have often been the longest lived. We find,
too, that our penitentiaries and insane asylums re-
ceive the larger portion of their inmates from the un-
cultured brains and from those whose mental sys-
tems have been starved and perverted by improper
food, bad air and depraved associations.
In the six chapters of Dr. Gorton's book, he
treats of the mental influence of physical agents,
the reciprocal influence of corporeal and mental ex-
ercise, moral and religious influences, moral agents
and influences, and very appropriately closes with a
chapter on marriage. The whole subject is handled
with great breadth of thought and richness of illus-
trations, in which some of the ablest writers upon
the subject are fully quoted. We commend the
work not only to the professional man but the gen-
eral reader.
Annual Record of Homoeopathic Literature,
1873. Edited by C. G. Raue, M. D. New York,
BOERICKE & Tafel, 145 Grand St.; Philadelphia,
635 Arch St.
This is the fourth volume of the "Annual Record
of Homoeopathic Literature." In its preparation the
editor and his associates have consulted the leading
homoeopathic journals of the world and the transac-
tions of State and foreign medical Societies where-
ever published, gleaning from their pages the ob-
servations and discoveries of a host of workers.
Notwithstanding much that is utterly worthless and
calculated to bring discredit upon our school has
unfortunately been introduced into the volume, still
the industrious editor and his assistants have gathered
together a vast amount of really interesting and
valuable matter, which will prove of great help to
the busy practitioner. A mind of ordinary discrim-
ination will find but little difficulty in rejecting the
worthless and seizing hold and appropriating to its
own use that which is really good. These annual
records, we have no doubt, will find their way into
the library of almost every homoeopathic physician
who wishes to be fully up to the times, and second
to his materia medica will be more consulted in his
daily work than any other book on his shelves.
The materia medica part has been arranged by
Dr. C. Herring, the surgical part by Dr. Macfarlan,
and the rest by the editor. The subjects are classi-
fied under appropriate heads. Under the head of
" Theory " a vast amount of extremely interesting
scientific matter has been introduced upon posology,
climatology, physiology, chemistry, including the
chemical examination of urine, and presenting upon
these subjects, carefully condensed, the most recent
discoveries.
The work forms a neat and well printed volume,
and sells for five dollars.
Catalogue of the Valuable Importations
of scribner, welford & armstrong, 654
Broadway.
We feel that we are doing our readers a real service
in calling their attention to this catalogue, as it
comprises the most important works in the various
departments of science and in general literature.
Every professional man feels at times the difficulty
of not knowing just where to go for the information
he desires. With this catalogue before him he can
turn to a list of the very best authors upon the sub-
ject of his investigations, and can therefore put
himself at once in possession of the desired infor-
mation without the trouble of overhauling the shelves
of a large library. Mr. Kernot, who has charge of
the foreign book department, is himself a walking
cyclopaedia and will quietly place in your hands the
very book you desire at the slightest hint of the
subject.
The Theory and Practice of Obstetrics.
By Wm. H. Byford, A. M., M. D., Professor of
Obstetrics and Diseases of Women and Children
in the Chicago Medical College, etc., etc. New
York, Wm. Wood & Co., 1873.
Looseness of construction and carelessness in ar-
rangement would seem inexcusable in a work pre-
tending to be scientific, if it were not that much val-
uable information would otherwise have been lost to
the profession. Unfortunately, diffusiveness and
obscureness of style has been a crying error with
very many of our writers ; but now, in the more ad-
vanced state of medical learning, inelegant produc-
tions are the exception rather than the rule.
The author, in the preface, says, that it has been
his aim to give a concise work to the profession,
which shall contain all the practical information
necessary to guide the student and busy practitioner
in the practice of this branch of our art. Although
he has carried out his purpose, yet the book would
have done the author far more justice if the sen-
tences had been more smoothly rounded and the
style more precise. His writings would indicate
him to be a popular practical lecturer, who knows
well how to adapt his subject to the short term of a
lecture course.
286
The Medical Union.
The greater portion of the book is devoted to the
pathology of parturition, and forms a very excellent
manual, as the rules for treatment embrace, for the
most part, the views of our advanced American au-
thorities. In internal medication he gives the im-
mense doses characteristic of some of our Western
practitioners, and often fires blunderbuss shots with
his compound prescriptions. A favorite formula of
his for inertia of the uterus contains Nux-Vomica to-
gether with Ergot. All recent physiological experi-
ments clearly prove that the action of these reme-
dies are directly antagonistic, the one congesting the
cord, and the other producing marked anaemia, and
that the value of Ergot as capable of arousing uterine
contractions resides in its characteristic action upon
this portion of the nervous system.
Homoeopaths are accustomed to study the action
of remedies from the more accurate stand-point of
"provings," and would easily discriminate that the
two remedies would not be indicated together.
The subject of placenta previa is very fully con-
sidered. He thinks that the teachings of the present
day inculcate too much interference in placental
presentation. " I am free," he says, " to say that I
regard it as over-treated. We take the whole matter
in our hands. If we have a case of placental presenta-
tion, we commence to dilate the os uteri, if it is not
dilated already, and as soon as it is dilated, or di-
latable, we proceed to deliver by forceps, if we can ;
if not, by turning; as a rule, by the latter opera-
tion. If the hemorrhage has not been considerable,
we turn for fear of bleeding, as bleeding is the rule.
Now, I think this is all wrong. We should stop the
hemorrhage if it has begun, prevent it if it has not
begun, and terminate the labor by interference only
because the powers of nature are insufficient. I be-
lieve that this unnecessary interference by introduc-
ing the hand and turning has had more victims than
unaided nature would have made in placenta previa.
The introduction of the hand necessitates fearful
loss of blood, in spite of the most dextrous manage-
ment; it causes so much irritation and abrasion as
to give rise to subsequent inflammation."
The writer thinks that the indication of prema-
ture labor is advisable in a very large class of cases,
and quotes Dr. Greenhalgh, Physician-Accoucheur
to St. Bartholomew's Hospital, London, to some
length, as strongly advocating the same views. " In
turning at the full term of gestation," Dr. Green-
halgh says, " that although it cannot be regarded
per se as a dangerous operation, yet when under-
taken in cases where the patient had been much
reduced, it proved fatal in 131 out of 512, one-in less
than four (Read), not to mention the amount of
fcetal mortality." If premature labor be induced,
he says, that " it would appear from large statistical
enquiries, that less than one mother in fifty-three
cases lost her life after this procedure ; and when
we bear in mind that in many of the recorded cases
this operation was adopted, in some on account of
great pelvic distortion, and in others where the pa-
tient's condition was most unsatisfactory, the mor-
tality may be even still further reduced." Dr. By-
ford then adds, that he feels justified in recommend-
ing the following practice: "That in any given
case of hemorrhage due to placenta previa, occur-
ring after seven and a-half months of utero-gesta-
tion, when the child is viable, it is expedient, both
for the safety of mother and child, to expedite la-
bor, unless the condition of the patient from ex-
haustion, be such as to preclude this step, and, if
so, then as soon as possible after she has recovered
from the shock, by every means in our power ; that
in so doing we should arouse the uterus to vigorous
action; and while on the one hand, we take due
precaution to arrest all external flow of blood from
the vagina, we should, on the other, adopt such
means as will effectually prevent any accumulation
of blood in the cavity of the uterus, at the same
time that we endeavor to effect a gradual dilatation
of the parts. These ends are to be attained by
means of a vaginal plug, an elastic abdominal
bandage, and Ergot of Rye, with the occasional aid
of stimulating enemas, friction over the abdomen,
and sometimes rupture of the membranes; turning
only in cases of presentations of the upper extremi-
ties ; the forceps where, from inefficient action of
the uterus, or slight mechanical impediments, ar-
rest takes place in the passage of the head through
the pelvis; and craniotomy in more serious cases of
disparagement in size between the presenting part
and the pelvis."
The work is profusely illustrated with elegant en-
gravings, which renders the book valuable to stu-
dents who have no manikin with which to learn
the manual part of midwifery. It is elegantly
printed, and the book will form a handsome addi-
tion to a physician's library.
Scientific iBleanings.
Curability of Pulmonary Phthisis. — An
article published by Dr. R. Massini, of Basle, in
Deutsch A re Mv. fur Klin. Med. (H. 3 and 4, 1873),
contains the following remarks on the above sub-
ject, the results of the author's personal experience:
In pulmonary phthisis, two-thirds of the fatal cases
belong to cheesy pneumonia, and in only one-third
of cases is tubercle to be found. It is impossible
in our present state of knowledge to assert that
miliary tubercle is curable. It is shown by the re-
sults of post-mortem examinations (discovery of
cicatrices in the apices of the lungs) that cheesy
pneumonia, when not complicated with tubercle,
can be cured. Pulmonary phthisis, adds* Dr. Mas-
sini, is frequently a consequence of abdominal
typhus ; and at Basle, mortality through typhus has
considerably diminished since the decrease of cases
of abdominal typhus.
Treatment of Gonorrhoea by Tanno-
Glycerine Paste. — Dr. Tonowitz, K. K., Regi-
ments Arzt, Austrian Army, reports the successful
employment of a modified Schuster's (aix-la-chap-
elle) tanno-glycerine paste for syphilis and gonor-
rhoea. His formula is as follows : r> Acidi Tannici,
3ss. ; Opii Pulveris, gr. iv. ; Glycerine, q. s. ut ft.
Pasta. Some 50-60 drops of glycerine are requisite
to bring the paste to a proper consistency. A
sound, or elastic bougie, is dipped into the paste,
warmed over a stove or spirit lamp, and, thus
smeared, is introduced into the orificium penis to
the fossa navicularis, where it is held for five
minutes. This operation is repeated three times a-
day. In gleet the catheter or bougie is carried
back to the bladder, and slowly withdrawn, so as to
bring the paste into contact with every surface of
the urethra. Even in acute cases the pain is but
very slight,
The Medical Union.
287
Tonsillitis Cured by Baryta Carbonica.
— Dr. Ransford, in the British Journal of Homoe-
opathy, gives several cases of Tonsillitis cured by-
Baryta Carbonica. In his estimation, the Baryta
acts in this disease more promptly, and is more
strictly homoeopathic than either Belladonna or
Mercurius.
Pregnancy in the Aged. — Dr. Meynert has
communicated to us the following case, which has
fallen under his own observation :
A lady died at the age of eighty- five years, having
had four accouchements. The first took place at the
age of forty, the second at forty-eight, the third at
fifty-one, and the fourth at fifty-six. Five girls were
born, of whom three are still living, the two twins
being seventy-seven years old, and the youngest
child seventy-one years. These three persons, the
two eldest of whom have been married, and have
several children, still enjoy the most excellent health.
— Lyon Medicate.
A German physician, Dr. Leuder, proposes an
easy means of ozonizing the air of sick-rooms. He
recommends the use of a powder, composed of per-
oxide of manganese, permanganate of potash, and
oxalic acid, which has the property of giving out,
in contact with water, an abundance of ozone. For
a chamber of middling size he uses about two table-
spoonfuls of the powder, over which he pours about
one table-spoonful of water every two hours. In
this way the quantity of ozone produced is exactly
what is wanted ; a larger quantity in the air would
occasion a cough. All kinds of metals, except gold
and platina, must be removed from the room, on
account of the oxidizing effects of the ozone.
The Echises Scholaris and the Garcinia
Mangostana. — These two new remedies were pre-
sented at the late International Exhibition in Vienna.
The bark of the first tree is considered a specific
remedy against all kinds of fevers. Mr. Gruppe, of
Manilla, has extracted from it a bitter principle,
called ditaina, which he considers better than the
sulphate of quinine, and much cheaper. From the
fruit of the second, the same chemist has extracted
a fluid called Anti-Dysenteric Extract of Garcinia
Mangostana. This extract has proved a very valu-
able remedy in dysentery, chronic diarrhoea, ca-
tarrhal affections of the uterus and bladder, and in
all affections where astringents are indicated.
Artificial Fibrin from the White of
EGG. — Dr. John Goodman, in a series of articles in
the London journals, warmly commends what he
calls artificial fibrin as a very nutritious substance,
capable of being administered to invalids, under cir-
cumstances where other food is not acceptable. It is
formed by emptying the albumen or white of the egg
into cold water, and allowing it to remain there for
twelve or more hours. In this time it undergoes a
chemical molecular change, becoming solid and in-
soluble, assuming an opaque and snowy white ap-
pearance. This, and the fluid in which it was im-
mersed, only require to be heated to the boiling
point to render the fibrin ready for use. It is easy
to digest, and very palatable, and is considered as a
great culinary delicacy. It is said that the stomach
will retain this, in many cases, when anything else
is promptly rejected, its presence creating a craving
for more food, and thus promoting, instead of de-
creasing, the appetite.
Ammonia in Snake-Bites. — The Indian Gov-
ernment has formally thanked Professor Halford,
of Simla, for his able paper on "The Treatment
of Snake-Bites, by the Injection of Liquor Ammo-
nias into the Veins," and has also decided to reprint
Dr. Halford's pamphlet, for general distribution to
medical officers in India.
Treatment by this method is now conceded to be
the most efficacious yet discovered in cases of poi-
sonous snake-bite.
The most incredible statement is made by a cor-
respondent of the London Lancet, that, in some of
the manufacturing districts of England, where wo-
men are largely employed, the death-rate among
infants under one year old is from 50 to 90 per cent.
The cause of this fearful mortality the writer ascribes
to the fact that the infants are left at home under
the care of ignorant elderly women, who feed them
with starch food, as : boiled bread, gruel, ground
rice, &c, substances which the infantile stomach
cannot digest, and which prove their certain de-
struction if given in sufficient quantity.
The Burnette process for embalming, or,
rather, preserving dead bodies, as given by The
Druggist, is as follows : ' ' The arteries and veins
are thoroughly washed out with cold water, till it
issues from the body colorless. This may occupy
from two to five hours. Alcohol is then injected to
abstract the water. This occupies about fifteen
minutes. Ether is next injected to abstract the
fatty matters, which it Hoes in from two to ten
hours. Finally, the body is dried in a current of
warm air passed over heated Chloride of Calcium.
This may occupy from two to five hours. The
Italians exhibit specimens of bodies preserved by
this process, which are as hard as stone, and per-
fect in form."
The Temperature of the Sexes : an Indi-
cation of Development. — Under this caption,
Dr. P. Stockton-Hough has published a very valu-
able paper, showing the most extensive researches
in biology. He tabulates his conclusions as follows :
1. That males have, as a rule, from the beginning
to the end of life, a higher temperature and a less
frequent pulsation of the heart than females ; vary-
ing, nevertheless, according to temperament, con-
stitution, age, and condition of health.
2. That children at birth, and for a short time
subsequently, have a high temperature, which,
though slightly slower than that of an adult, never-
theless slowly and gradually declines to a certain
point until about the sixth year of age is reached,
after which it gradually increases until develop-
mental maturity is reached, when it gradually and
slowly declines again as old age (second childhood),
advances.
The pulsation of the heart follows just the oppo-
site course, being most frequent when the temper-
ature is lowest, and least frequent when it is high-
est.
3. That males appear to have a greater variation
in temperature than females, thus agreeing with
their greater variation in stature and many other
peculiarities.
4. From all of which we conclude that the woman
approaches more to her condition as a child than
the man does, and is consequently less highly de-
veloped.
5S$
The Medical Union.
Dr. Favre communicated to the French Associ-
ation the results of his observations on Daltonism,
or color-blindness, in railroad employes. As physi-
cian to the Paris and Lyons Railway Company, he
has enjoyed special facilities in studying this ques-
tion, which has so important a bearing on the safety
of the traveling public. In 1196 men, examined
between 1864 and 1868, he found 13 cases of insen-
sibility to red rays, and one to green. Seven hun-
dred and twenty-eight men were examined in 1872-
1873, who presented 42 more or less clear cases of
Daltonism.
Dr. Favre insists on the necessity of frequently
examining the engineers, switchmen, and other em-
ployes who are charged with displaying and observ-
ing signals.
Unilateral Development. — Dr. Ringland
communicated to the Dublin Obstetrical Society
a remarkable case of this in a young lady, aet.
20, who had never menstruated naturally, but in
whom vicarious discharges, at each monthly period,
had occurred for more than four years through the
bladder, rectum, nose and eyes. The left side of the
body was perfectly formed, and developed sexually,
while the right was not so. The left breast was nor-
mal, the right resembled that of a girl of 12 ; there
was hair on the left side of the pubes, none on the
right ; the left labium was fully formed, the right
almost wanting. The clitoris, vagina and uterus
were absent. The left ovary could be felt, the
right could not be detected. Sexual desire existed
in this case, but a strong opinion as to the inadvisa-
bility of marriage was given.
Nutritious Injections — a New Method of
Nourishing Patients by the Anus.— M. Leube
has had the idea of rendering the digestion in the
large intestine very active by carrying into this
organ, simultaneously, digestible substances and a
substance which is digestive. The pancreas of the
hog constitutes the latter. The mass to be digested
is made in the following manner: Fifty to one hun-
dred grammes of the pancreas of the hog or ox,
carefully deprived of its fatty tissue, are chopped
fine and mixed with one hundred and fifty to two
hundred grammes of beef. The two substances are
pounded in a mortar with warm water, a magma
being formed which is injected by means of a
syringe, the nozzle of which is of large calibre.
The injections thus composed have given good re-
sults with dogs. A fecal mass is formed after the
injections which is quite analogous to the ordinary
matters ; the fat and the albumen are digested by
the large intestine. This method of nutrition has
been applied by the author to two patients. In one
case there was a cancer of the upper portion of the
digestive tube ; in the other the patient could not
receive any aliment without rejecting it by vomit-
ing. In these cases the pancreatic substances did
not cause any diarrhoea; they remained in the in-
testine for from twelve to thirty-six hours without
producing any evacuations, and the patients did
not experience any pain. After the injections the
stools became more full ; but at first the injections
were not entirely retained, the patients rejecting a
part of the injected mass undigested. This melange
is, according to the author, superior to all the sub-
stances which are recommended for nourishing by
the large intestines. — Gazette Hebdomadaire and
La Tribune Medicate,
A Wax Candle in the Bladder of a Fe-
male.— This interesting case was observed a short
time ago at the Hotel Dieu, of Paris. The patient?
on admission, complained of intense pain in the
abdomen. The urethra, abnormally dilated, easily
allowed of the introduction of a finger into the
bladder; when there was felt a hard, voluminous
body, obviously the cause of the intense pain. The
woman then mentioned that, on account of great
difficulty in making water, she had passed a candle
through the urethra, and had let it fall accidentally
into the bladder. Through the extraordinary dila-
tation of the urethra, pincers were easily passed
through the canal, and after some efforts, the candle
was caught by the wick and drawn out through the
urethra. The end of the candle (which had been
rounded by a knife) was seen to be covered with
calcareous matter, which had gathered there during
the five weeks which the candle • had stayed in the
bladder. A few days after the extraction, the wo-
man left the hospital perfectly recovered.
jNeuus 3iem$*
PROF. Czermak, the celebrated physiologist,
died at Leipsic, September 15th, 1873.
Proposed Monument to Eustachius. — The
city of Sanseverino-Marche, in Italy, has resolved to
erect a monument to its greatest citizen, Bartholo-
mew Eustachius, the great anatomist, philosopher
and physician of the sixteenth century.
The Khedive of Egypt is about to construct a
hospital at Emirghin, on the Bosphorus. The in-
stitution will, it is said, be a model one of its kind,
as , regards the plan for the complete separation of
the sexes, and of diseases of a contagious nature
from others, without interfering with the adminis-
tration of the establishment.
Mortality among Clergymen. — Of 236 cler-
gymen, whose death and ages were reported last
year, 7 were over 90 years old, 29 were between 80
and 90, 46 between 70 and 80, 49 between 60 and
70, 61 between 50 and 60, 23 between 40 and 50,
22 between 30 and 40, and 9 between 20 and 30.
The average age at death was about 61.
Papaya. — The sap of this tree is used in India to
make meat tender, and even the exhalations from
the tree have the same effect. Assistant Surgeon
Gopal Chunder Roy compares the action to that of
a ferment, and suggests the administration of a few
grains of the dried juice after meals, in cases of
indigestion caused by deficient secretion of gastric
juice.
The buildings of the great American Museum of
Natural History, in Central Park, New York, under
the immediate direction of Prof. Bickmore, have
been placed under contract and will furnish accom-
modation for a very large collection. The section
referred to is but a small portion, however, of the
contemplated edifice, which, when complete, will
cover over fifteen acres, being much the largest
establishment of the kind in the world.
Erratum. — In' the report of the October meet-
ing of the New York Homoeopathic Society, " nat-
rum muriaticum," in Dr. Liebold's article, should
read " chinin muriaticum,"
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